1.Laboratory of Emergency Medical Services,Seoul National University Hospital Biomedical Research Institute,Seoul,Korea.
Prehosp Disaster Med. 2019 Apr;34(2):142-148. doi: 10.1017/S1049023X19000207. Epub 2019 Apr 10.
Major incidents affecting large numbers of people may increase the rate of acute cardiovascular events, even among those who are not directly involved in the incident. It is hypothesized that the MV Sewol ferry disaster (South Korea) would increase the incidence of cardiovascular events nation-wide.
Data on all adult patients (>18 years) who were diagnosed with acute cardiovascular events, including acute myocardial infarction (MI), angina, and cardiac arrhythmias, were extracted from the National Emergency Department Information System (NEDIS) from March 15 through June 17, during the years 2011-2014 (four weeks before to eight weeks after the event date). Poisson regression models were used to calculate the incidence rate ratios (IRRs) comparing the weekly changes in the occurrences of cardiovascular events from the week of the Sewol event (April 16-22, 2014) to eight weeks after the disaster (June 11-17, 2014), using the one-month period before Sewol as a reference period (March 15-April 15), adjusting for calendar years (years 2011-2014) and environmental factors.
During the study periods, cardiovascular events were identified in 73,823 patients. Compared to the reference period, the week of the Sewol disaster and the three weeks after the disaster showed a significant increase in the number of acute cardiovascular events, IRRs of 1.09 (95% CI, 1.03-1.15) and 1.08 (95% CI, 1.02-1.15), respectively (P <.01 for both). In particular, there was 21% increase in incidence of arrhythmia (IRR = 1.21; 95% CI, 1.02-1.44; P = .03) during the week of the Sewol disaster compared with the reference period.
This study showed a significant increase in the incidence of acute cardiovascular events during the week of, and the three weeks after, the Sewol ferry disaster in 2014. These additional cardiac emergencies may be triggered by emotional stressors related to the event, highlighting the public health importance of indirect exposure to a tragic catastrophe.Kong SY, Song KJ, Shin SD, Ro YS. Cardiovascular events after the Sewol ferry disaster, South Korea. Prehosp Disaster Med. 2019;34(2):142-148.
影响大量人群的重大事件可能会增加急性心血管事件的发生率，即使是那些没有直接参与事件的人群。据推测，“世越号”客轮灾难（韩国）将在全国范围内增加心血管事件的发生率。
从 2011 年至 2014 年（事件发生日期前后 8 周内），从国家急救部门信息系统（NEDIS）中提取所有成年患者（>18 岁）的急性心血管事件（包括急性心肌梗死（MI）、心绞痛和心律失常）的数据。使用泊松回归模型计算每周心血管事件发生率（IRR）的变化，比较世越号事件（2014 年 4 月 16 日至 22 日）当周与世越号灾难后 8 周（2014 年 6 月 11 日至 17 日）的每周变化，以世越号事件前一个月（2014 年 3 月 15 日至 4 月 15 日）为参考期，调整日历年份（2011 年至 2014 年）和环境因素。
在研究期间，共确定了 73823 名患者患有心血管事件。与参考期相比，世越号灾难当周和灾难后 3 周急性心血管事件数量显著增加，IRR 分别为 1.09（95%CI，1.03-1.15）和 1.08（95%CI，1.02-1.15）（均<0.01）。特别是，与参考期相比，世越号灾难当周心律失常的发病率增加了 21%（IRR=1.21；95%CI，1.02-1.44；P=0.03）。
本研究表明，2014 年“世越号”客轮灾难期间及其后三周，急性心血管事件的发生率显著增加。这些额外的心脏急症可能是由与事件相关的情绪压力引发的，突显出间接暴露于悲惨灾难对公共卫生的重要性。
