Survival and cost analysis of fatalities of the Kobe earthquake in Japan. Export

@article{citeulike:563974, abstract = {OBJECTIVES: The authors investigated the dying patterns, and cause and preventability of deaths in a major earthquake disaster, and estimated the cost needed to enhance emergency medical services (EMS) response to prevent "unnecessary" deaths. METHODS: The authors reviewed autopsy data in the Hanshin-Awaji (Kobe) earthquake of 1995. A survival analysis was performed to determine the time course and pattern of dying of these deaths. A cost analysis to estimate acceptable cost for EMS to reduce fatalities was also performed. Potentially salvageable life-years based on expected life-years among fatalities were calculated and used to simulate an acceptable cost for an enhanced EMS disaster response. RESULTS: The authors analyzed 5,411 fatalities. More than 80\% of these patients died within three hours. There were statistically significant differences in survival/dying patterns among causes of death. Thirteen percent of victims experienced a protracted death, which could have been prevented with earlier medical or surgical intervention. The monetary cost of these lost lives was estimated at approximately 600 million US dollars. CONCLUSIONS: Survival analysis revealed a significant population of potentially salvageable patients if more timely and appropriate medical intervention had been available immediately after the earthquake. Based on our cost analysis, and assuming a 1\% annual probability of an earthquake and a 30\% enhanced lifesaving capability of the EMS effort, approximately \$ million dollars annually could be a reasonable expenditure to achieve the goal of reducing preventable deaths in disasters.}, address = {School of Health Information Sciences, University of Texas Health Science Center-Houston, Houston, Texas 77030, USA. noriaki.aoki@uth.tmc.edu}, author = {Aoki, N. and Nishimura, A. and Pretto, E. A. and Sugimoto, K. and Beck, J. R. and Fukui, T.}, citeulike-article-id = {563974}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/15060860}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=15060860}, issn = {1090-3127}, journal = {Prehosp Emerg Care}, keywords = {cost, earthquake, prehospital}, number = {2}, pages = {217--222}, posted-at = {2006-03-26 16:15:29}, priority = {1}, title = {Survival and cost analysis of fatalities of the Kobe earthquake in Japan.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/15060860}, volume = {8}, year = {2004} }

TY - JOUR ID - citeulike:563974 L3 - citeulike-article-id:563974 N2 - OBJECTIVES: The authors investigated the dying patterns, and cause and preventability of deaths in a major earthquake disaster, and estimated the cost needed to enhance emergency medical services (EMS) response to prevent "unnecessary" deaths. METHODS: The authors reviewed autopsy data in the Hanshin-Awaji (Kobe) earthquake of 1995. A survival analysis was performed to determine the time course and pattern of dying of these deaths. A cost analysis to estimate acceptable cost for EMS to reduce fatalities was also performed. Potentially salvageable life-years based on expected life-years among fatalities were calculated and used to simulate an acceptable cost for an enhanced EMS disaster response. RESULTS: The authors analyzed 5,411 fatalities. More than 80% of these patients died within three hours. There were statistically significant differences in survival/dying patterns among causes of death. Thirteen percent of victims experienced a protracted death, which could have been prevented with earlier medical or surgical intervention. The monetary cost of these lost lives was estimated at approximately 600 million US dollars. CONCLUSIONS: Survival analysis revealed a significant population of potentially salvageable patients if more timely and appropriate medical intervention had been available immediately after the earthquake. Based on our cost analysis, and assuming a 1% annual probability of an earthquake and a 30% enhanced lifesaving capability of the EMS effort, approximately $ million dollars annually could be a reasonable expenditure to achieve the goal of reducing preventable deaths in disasters. IS - 2 JF - Prehosp Emerg Care SN - 1090-3127 AD - School of Health Information Sciences, University of Texas Health Science Center-Houston, Houston, Texas 77030, USA. noriaki.aoki@uth.tmc.edu EP - 222 TI - Survival and cost analysis of fatalities of the Kobe earthquake in Japan. VL - 8 SP - 217 KW - cost KW - earthquake KW - prehospital AU - Aoki, N AU - Nishimura, A AU - Pretto, EA AU - Sugimoto, K AU - Beck, JR AU - Fukui, T PY - 2004///n UR - http://view.ncbi.nlm.nih.gov/pubmed/15060860 ER -