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《美属维尔京群岛:2017 年依玛飓风和玛丽亚飓风过后圣托马斯岛急诊部和创伤护理诊所的使用情况》

Powerless in the Virgin Islands: Emergency Department and Wound Care Clinic Utilization Following the 2017 Hurricanes Irma and Maria on St. Thomas, U.S. Virgin Islands.

机构信息

College of Health and Human Services, George Mason University, Fairfax, VA, USA.

Department of Public and Community Health, School of Health Sciences, Liberty University, Lynchburg, VA, USA.

出版信息

Disaster Med Public Health Prep. 2021 Oct 22;17:e50. doi: 10.1017/dmp.2021.301.

Abstract

OBJECTIVE

The main objective of this work was to characterize the prevalence of acute medical needs by examining emergency department (ED) and outpatient wound care clinic (WCC) visits before, during, and after the 2017 Hurricanes Irma and Maria, in St. Thomas, United States (U.S.) Virgin Islands.

METHODS

Descriptive statistics and logistic regression were used to assess associations between the occurrence of the storms and visits due to injuries and chronic conditions presented to the ED and WCC from September 1, 2016 to May 31, 2018.

RESULTS

ED visits increased and the rate of injury care was higher during the storms (12 patient visits per day) than before or after the storms (9 patient visits per day). WCC visits increased during (12%) and after the storms (45%), and were associated with patients 60 years and older. The odds of ED and WCC visits due to injury during the storms were significantly higher (odds ratio [OR]: 1.28, 95% confidence interval [CI]: 1.17, 1.40) than prior to the storms. The odds for visits due to injuries were 1.19 (95% CI: 1.12, 1.28) times higher after the storms.

CONCLUSIONS

Increases occurred in ED and WCC visits for injury care during the storms and in WCC visits after the storms. Public health preparedness mandates understanding how major hurricanes impact the prevalence of acute medical needs, and the factors that influence decisions to seek medical care, in their wake.

摘要

目的

本研究旨在通过考察 2017 年美国维尔京群岛圣托马斯的飓风“艾玛”和“厄玛”前后,急诊部(ED)和门诊伤口护理诊所(WCC)就诊的急性医疗需求,来描述其特征。

方法

采用描述性统计和逻辑回归分析,评估风暴发生前后,ED 和 WCC 因损伤和慢性疾病就诊的情况与风暴发生之间的关联。

结果

ED 就诊次数增加,风暴期间(每天 12 人次就诊)的外伤护理率高于风暴前(每天 9 人次就诊)或风暴后(每天 9 人次就诊)。WCC 的就诊次数在风暴期间(增加 12%)和风暴后(增加 45%)增加,与 60 岁及以上患者相关。与风暴前相比,风暴期间 ED 和 WCC 因外伤就诊的几率显著增加(优势比[OR]:1.28,95%置信区间[CI]:1.17,1.40)。风暴后,因外伤就诊的几率增加 1.19 倍(95% CI:1.12,1.28)。

结论

风暴期间 ED 和 WCC 的外伤护理就诊次数增加,风暴后 WCC 的就诊次数增加。公共卫生应急管理需要了解大型飓风如何影响急性医疗需求的流行,以及在飓风过后,哪些因素影响人们就医的决策。

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