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《特大地震后从福岛第一核电站附近医院撤离的患者的长期预后》

Long-term outcomes of patients evacuated from hospitals near the Fukushima Daiichi nuclear power plant after the Great East Japan Earthquake.

机构信息

Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan.

Health Services and Systems Research, Duke-NUS Medical School, Singapore.

出版信息

PLoS One. 2018 Apr 17;13(4):e0195684. doi: 10.1371/journal.pone.0195684. eCollection 2018.

Abstract

INTRODUCTION

After the accident of the Fukushima Daiichi nuclear power plant due to the Great East Japan Earthquake in March 2011, the Japanese government issued a mandatory evacuation order for people living within a 20 km radius of the nuclear power plant. The aim of the current study was to investigate long-term outcomes of these patients and identify factors related to mortality.

MATERIALS AND METHODS

Patients who were evacuated from hospitals near the Fukushima Daiichi nuclear power plant to the Aizu Chuo Hospital from 15 to 26 March, 2011 were included in this study. The following data were collected from medical records: age, sex, activities of daily life, hospital they were admitted in at the time of earthquake, distance between the facility and the nuclear power plant, reasons of evacuation and number of transfers. The patient outcomes were collected from medical records and/or investigated on the telephone in January 2012.

RESULTS

A total of 97 patients (28 men and 69 women) were transferred from 10 hospitals via ambulances or buses. No patients died or experienced exacerbation during transfer. Median age of the patients was 86 years. Of the total, 36 patients were not able to obey commands, 44 were bed-ridden and 61 were unable to sustain themselves via oral intake of food. Among 86 patients who were followed-up, 41 (48%) died at the end of 2011. Multiple-regression analysis showed that non-oral intake [Hazard Ratio (HR): 6.07, 95% Confidence interval (CI): 1.94-19.0] and male sex [HR: 8.35, 95% CI: 2.14-32.5] had significant impact on mortality.

CONCLUSION

This study found that 48% of the evacuated patients died 9 months after the earthquake and they had significantly higher mortality rate than the nursing home residents. Non-oral intake and male sex had significant impact on mortality. These patients should be considered as especially vulnerable in case of hospital evacuation.

摘要

简介

2011 年 3 月东日本大地震后,福岛第一核电站发生事故,日本政府对核电站周围 20 公里范围内的居民发布了强制疏散令。本研究旨在调查这些患者的长期预后,并确定与死亡率相关的因素。

材料和方法

本研究纳入了 2011 年 3 月 15 日至 26 日从福岛第一核电站附近的医院转移到会津中央医院的患者。从病历中收集了以下数据:年龄、性别、日常生活活动、地震时住院的医院、设施与核电站的距离、疏散原因和转院次数。患者的预后情况从病历中收集或于 2012 年 1 月通过电话调查。

结果

共有 97 名患者(28 名男性和 69 名女性)通过救护车或巴士从 10 家医院转移而来。在转移过程中,没有患者死亡或病情恶化。患者的中位年龄为 86 岁。其中,36 名患者无法听从指令,44 名患者卧床不起,61 名患者无法通过口服摄入食物维持生命。在 86 名接受随访的患者中,有 41 名(48%)在 2011 年底死亡。多因素回归分析显示,不能经口进食[风险比(HR):6.07,95%置信区间(CI):1.94-19.0]和男性[HR:8.35,95%CI:2.14-32.5]对死亡率有显著影响。

结论

本研究发现,地震后 9 个月,97 名疏散患者中有 48%死亡,其死亡率明显高于养老院居民。不能经口进食和男性对死亡率有显著影响。在医院疏散时,这些患者应被视为特别脆弱的人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f01f/5903607/29be0bd33c5c/pone.0195684.g001.jpg

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