Epidemiology of traumatic falls after Hurricane Maria in Puerto Rico

Abstract

Background: Hurricanes are among the most devastating natural disasters, playing a significant role in public health. Currently, the epidemiology of fall-related injuries after the occurrence of a tropical storm is not well described. This study aims to compare the demographical patterns, clinical profile, hospital course, and costs of patients admitted to the Puerto Rico Trauma Hospital before and after Hurricane Maria. Methods: A retrospective study was performed to compare fall-related injuries after the hurricane (September 20, 2017-January 20, 2018) with a control period (same period in 2014-2016). Comparison between the groups was done using chi-square, Mann-Whitney test, and logistical regression. Results: After the hurricane, there was an increase in the proportion of fall-related admissions in subjects aged 40-64 years (39.2% vs. 50.6%) and a decrease among those aged 18-39 years (16.0% vs. 5.9%), when compared with the previous years. A greater proportion of patients presented with work related injuries (3.9% vs. 9.4%). No significant differences were identified for sex, Glasgow Coma Scale, Injury Severity Score, and hospital outcomes (hospital and intensive care unit days, mechanical ventilation, and mortality). Intracranial injuries were marginally higher post-Maria (p = 0.06). In multivariate analysis, during the post-Maria period, an increased risk of fall-related injuries was observed among subjects ≥40 years (OR: 3.20) and injuries related to recovery work (OR: 2.64) (p < 0.05). Conclusions: Our study shows that there is an increased risk of fall-related injuries among middle-aged individuals after a hurricane, causing significant changes in epidemiology. This study helps to elucidate the health consequences of falls and, in doing so, improves healthcare preparedness, interventions, and planning for future natural disasters.

Impact of Hurricane Maria on Drinking Water Quality in Puerto Rico

“…On 20 September 2017, Hurricane Maria (HM) made direct landfall south of Yabucoa Harbor in Puerto Rico (PR) as a strong Category 4 storm, resulting in catastrophic flash floods and island-wide devastation. , HM directly killed 64 people in PR with excess deaths estimated from 990 to 4645, destroyed over 90% of the electrical systems and 80% of the agricultural sectors, and left large areas without communication, water, and health care services, all of which resulted in an extremely slow posthurricane recovery. , Limited studies on the impact of HM have reported increasing rates of adverse physical and psychological health consequences (e.g., fall-related injuries, leptospirosis infection, anxiety, post-traumatic stress) − and hurricane-exacerbated environmental effects including persistent hydrological disruption, deterioration of coastal water quality, increased air pollution, and disturbance of forest ecosystems. , However, little is known about the disruption of HM on drinking water quality that is critical to waterborne/water-related disease control and public health protection …”

Impact of Hurricanes Irma and Maria on Asthma, Hypertension, and Depression in a Sample of the Puerto Rico Population

“…36 While previous research in Puerto Rico in the context of Hurricanes Irma and Maria has focused on mortality, injuries, mental health, and nutrition, results from this study demonstrate that there is also a need to evaluate and plan for chronic diseases in this context. [11][12][13][14][15][16]36,37 Understanding the impact that natural disasters, like hurricanes, exert on the health of populations with chronic conditions or those at high risk of developing NCDs will help inform further efforts. The information obtained from this study is useful to develop better preparedness strategies from a public health perspective.…”

Natural Disasters Related Traumatic Injuries/Fatalities in the United States and Their Impact on Emergency Preparedness Operations

“…Equally as important as ensuring proper preparedness for sudden and deadly weather events is the maintenance of acute care and trauma surge capacity in the immediate time period after the natural disaster has passed. Previous studies have shown that certain categories of injuries can have a high incidence for weeks following natural disasters due to hazardous environmental conditions (Ramírez-Martínez et al, 2020). For example, the Task Force for Pediatric Emergency Mass Critical Care has made specific recommendations for hospitals endemic to disaster-prone areas to have three times the supplies and equipment above usual intensive care unit capacity in order to adequately manage pediatric surge patients for at least 10 days following natural disasters (Bohn et al, 2011).…”