Am J Epidemiol. 2021 Oct 1;190(10):2138-2147. doi: 10.1093/aje/kwab127.
The magnitude, timing, and etiology of morbidity associated with tropical cyclones remains incompletely quantified. We examined the relative change in cause-specific emergency department (ED) visits among residents of New York City during and after Hurricane Sandy, a tropical cyclone that affected the northeastern United States in October 2012. We used quasi-Poisson constrained distributed lag models to compare the number of ED visits on and after Hurricane Sandy with all other days, 2005-2014, adjusting for temporal trends. Among residents aged ≥65 years, Hurricane Sandy was associated with a higher rate of ED visits due to injuries and poisoning (relative risk (RR) = 1.19, 95% confidence interval (CI): 1.10, 1.28), respiratory disease (RR = 1.35, 95% CI: 1.21, 1.49), cardiovascular disease (RR = 1.10, 95% CI: 1.02, 1.19), renal disease (RR = 1.44, 95% CI: 1.22, 1.72), and skin and soft tissue infections (RR = 1.20, 95% CI: 1.03, 1.39) in the first week following the storm. Among adults aged 18-64 years, Hurricane Sandy was associated with a higher rate of ED visits for renal disease (RR = 2.15, 95% CI: 1.79, 2.59). Among those aged 0-17 years, the storm was associated with lower rates of ED visits for up to 3 weeks. These results suggest that tropical cyclones might result in increased health-care utilization due to a wide range of causes, particularly among older adults.
与热带气旋相关的发病率的严重程度、时间和病因仍未完全量化。我们研究了 2012 年 10 月袭击美国东北部的热带气旋“桑迪”过后,纽约市居民因特定病因前往急诊室(ED)就诊的相对变化。我们使用准泊松约束分布滞后模型,比较了桑迪飓风期间和之后的 ED 就诊人数与 2005-2014 年所有其他日子的就诊人数,同时调整了时间趋势。在年龄≥65 岁的居民中,桑迪飓风与因伤害和中毒导致的 ED 就诊率升高有关(相对风险(RR)=1.19,95%置信区间(CI):1.10,1.28)、呼吸系统疾病(RR=1.35,95%CI:1.21,1.49)、心血管疾病(RR=1.10,95%CI:1.02,1.19)、肾脏疾病(RR=1.44,95%CI:1.22,1.72)和皮肤及软组织感染(RR=1.20,95%CI:1.03,1.39)在风暴后的第一周。在 18-64 岁的成年人中,桑迪飓风与肾脏疾病的 ED 就诊率升高有关(RR=2.15,95%CI:1.79,2.59)。在 0-17 岁的人群中,风暴在多达 3 周的时间里与 ED 就诊率降低有关。这些结果表明,热带气旋可能会导致因各种原因导致的医疗保健利用率增加,尤其是在老年人中。