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自然灾害与心肌梗死:卡特里娜飓风过后的六年

Natural disasters and myocardial infarction: the six years after Hurricane Katrina.

机构信息

Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, LA.

Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, LA.

出版信息

Mayo Clin Proc. 2014 Apr;89(4):472-7. doi: 10.1016/j.mayocp.2013.12.013. Epub 2014 Mar 18.

Abstract

OBJECTIVE

To determine the prolonged effect of Hurricane Katrina on the incidence and timing of acute myocardial infarction (AMI) in the city of New Orleans.

PATIENTS AND METHODS

Our study population consisted of 1476 patients with AMI before (August 29, 1999, to August 28, 2005) and after (February 14, 2006, to February 13, 2012) Hurricane Katrina at Tulane University Health Sciences Center to determine post-Katrina alterations in the occurrence and timing of AMI.

RESULTS

Compared with pre-Katrina values, there was a more than 3-fold increase in the percentage of admissions for AMI during the 6 years after Hurricane Katrina (P<.001). The percentage of admissions for AMI after Hurricane Katrina increased significantly on nights (P<.001) and weekends (P<.001) and decreased significantly on mornings (P<.001), Mondays (P<.001), and weekdays (P<.001). Patients with AMI after Hurricane Katrina also had significantly higher rates of psychiatric comorbidities (P=.01), smoking (P<.001), lack of health insurance (P<.05), and unemployment (P<.001).

CONCLUSION

These results indicate that the effect of natural disasters on the occurrence of AMI may persist for at least a 6-year period and may be related to various factors including population shifts, alterations in the health care system, and the effects of chronic stress and associated behaviors.

摘要

目的

确定卡特里娜飓风对新奥尔良市急性心肌梗死(AMI)发病率和发病时间的长期影响。

患者和方法

我们的研究人群包括在杜兰大学健康科学中心接受治疗的 1476 例 AMI 患者,这些患者分为飓风前(1999 年 8 月 29 日至 2005 年 8 月 28 日)和飓风后(2006 年 2 月 14 日至 2012 年 2 月 13 日)两组,以确定卡特里娜飓风后 AMI 发病和发病时间的变化。

结果

与飓风前相比,飓风后 6 年 AMI 住院率增加了 3 倍以上(P<.001)。飓风后 AMI 住院率在夜间(P<.001)和周末(P<.001)显著增加,而在早晨(P<.001)、周一(P<.001)和工作日(P<.001)显著减少。与飓风前相比,飓风后发生 AMI 的患者还存在更高的精神共病率(P=.01)、吸烟率(P<.001)、缺乏医疗保险率(P<.05)和失业率(P<.001)。

结论

这些结果表明,自然灾害对 AMI 发生的影响可能持续至少 6 年,可能与人口转移、医疗保健系统变化以及慢性应激和相关行为的影响等多种因素有关。

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