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首页> 外文期刊>Prehospital and disaster medicine : >Survey of preventable disaster death at medical institutions in areas affected by the great East Japan Earthquake: A retrospective preliminary investigation of medical institutions in miyagi prefecture
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Survey of preventable disaster death at medical institutions in areas affected by the great East Japan Earthquake: A retrospective preliminary investigation of medical institutions in miyagi prefecture

机译：东日本大地震地区医疗机构可​​预防的灾难性死亡调查：宫城县医疗机构的回顾性初步调查

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Problem The 2011, magnitude (M) 9, Great East Japan Earthquake and massive tsunami caused widespread devastation and left approximately 18,500 people dead or missing. The incidence of preventable disaster death (PDD) during the Great East Japan Earthquake remains to be clarified; the present study investigated PDD at medical institutions in areas affected by the Great East Japan Earthquake in order to improve disaster medical systems. Methods A total of 25 hospitals in Miyagi Prefecture (Japan) that were disaster base hospitals (DBHs), or had at least 20 patient deaths between March 11, 2011 and April 1, 2011, were selected to participate based on the results of a previous study. A database was created using the medical records of all patient deaths (n=868), and PDD was determined from discussion with 10 disaster health care professionals. Results A total of 102 cases of PDD were identified at the participating hospitals. The rate of PDD was higher at coastal hospitals compared to inland hospitals (62/327, 19.0% vs 40/541, 7.4%; P<.01). No difference was observed in overall PDD rates between DBHs and general hospitals (GHs); however, when analysis was limited to cases with an in-hospital cause of PDD, the PDD rate was higher at GHs compared to DBHs (24/316, 7.6% vs 21/552, 3.8%; P<.05). The most common causes of PDD were: insufficient medical resources, delayed medical intervention, disrupted lifelines, deteriorated environmental conditions in homes and emergency shelters at coastal hospitals, and delayed medical intervention at inland hospitals. Meanwhile, investigation of PDD causes based on type of medical institution demonstrated that, while delayed medical intervention and deteriorated environmental conditions in homes and emergency shelters were the most common causes at DBHs, insufficient medical resources and disrupted lifelines were prevalent causes at GHs. Conclusion Preventable disaster death at medical institutions in areas affected by the Great East Japan Earthquake occurred mainly at coastal hospitals. Insufficient resources (at GHs), environmental factors (at coastal hospitals), and delayed medical intervention (at all hospitals) constituted the major potential contributing factors. Further investigation of all medical institutions in Miyagi Prefecture, including those with fewer than 20 patient deaths, is required in order to obtain a complete picture of the details of PDD at medical institutions in the disaster area. Yamanouchi S, Sasaki H, Tsuruwa M, Ueki Y, Kohayagawa Y, Kondo H, Otomo Y, Koido Y, Kushimoto S.
机译：问题2011年，东日本大地震（M）9级和海啸造成了广泛的破坏，大约18,500人丧生或失踪。东日本大地震期间可预防的灾害死亡（PDD）的发生率仍有待澄清;本研究在东日本大地震影响地区的医疗机构中调查了PDD，以改善灾难医疗系统。方法根据先前的结果，选择日本宫城县的25家医院作为灾难基础医院（DBH），或在2011年3月11日至2011年4月1日之间至少有20例患者死亡。研究。使用所有患者死亡的医疗记录（n = 868）创建了一个数据库，并通过与10名灾难卫生保健专业人员的讨论确定了PDD。结果参与医院共鉴定出102例PDD病例。与内陆医院相比，沿海医院的PDD发生率更高（62/327，19.0％，40/541，7.4％; P <.01）。 DBH和综合医院（GH）之间的总体PDD率没有差异;然而，当分析仅限于院内引起PDD的病例时，GHs的PDD率高于DBHs（24 / 316，7.6％，而21 / 552，3.8％; P <.05）。 PDD的最常见原因是：医疗资源不足，医疗干预延迟，生命线中断，沿海医院的家庭和急诊室的环境条件恶化以及内陆医院的医疗干预延迟。同时，基于医疗机构类型的PDD原因调查表明，尽管延迟医疗干预以及家庭和紧急避难所环境条件恶化是DBH的最常见原因，但医疗资源不足和生命线中断是GH的普遍原因。结论东日本大地震灾区的医疗机构可​​预防的灾难性死亡主要发生在沿海医院。主要的潜在影响因素包括资源不足（GHs），环境因素（沿海医院）和延迟的医疗干预（所有医院）。为了对灾区医疗机构的PDD详细情况有完整的了解，需要对宫城县的所有医疗机构进行进一步调查，包括患者死亡人数少于20人。 Yamanouchi S，Sasaki H，Tsuruwa M，Ueki Y，Kohayagawa Y，Kondo H，Otomo Y，Koido Y，Kushimoto S.

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