Key result
Japan earthquake and tsunami linked to ~4.7-fold higher in-hospital mortality among STEMI patients.
Why the study?
The impact of the Japan earthquake disaster with massive Tsunami on reperfusion rate, therapeutic time course, and in-hospital mortality in STEMI patients was unclear.
Cohort (n=386)
Yes
Answers are grounded in this paper and cite their sources.
STEMI systems in disaster zones warrant heightened readiness; observational data leaves open causal mechanisms and mitigation strategies.
AIMS: The aims of this study were to evaluate reperfusion rate, therapeutic time course and in-hospital mortality pre- and post-Japan earthquake disaster, comparing patients with ST-elevation myocardial infarction (STEMI) treated in the inland area or the Tsunami-stricken area of Iwate prefecture. METHOD AND RESULTS: Subjects were 386 consecutive STEMI patients admitted to the four percutaneous coronary intervention (PCI) centers in Iwate prefecture in 2010 and 2011. Patients were divided into two groups: those treated in the inland or Tsunami-stricken area. We compared clinical characteristics, time course and in-hospital mortality in both years in the two groups. PCI was performed in 310 patients (80.3%). Door-to-balloon (D2B) time in the Tsunami-stricken area in 2011 was significantly shorter than in 2010 in patients treated with PCI. However, the rate of PCI performed in the Tsunami-stricken area in March-April 2011 was significantly lower than that in March-April 2010 (41.2% vs 85.7%; p=0.03). In-hospital mortality increased three-fold from 7.1% in March-April 2010 to 23.5% in March-April 2011 in the Tsunami-stricken area. Standardized mortality ratio (SMR) in March-April 2011 in the Tsunami-stricken area was significantly higher than the control SMR (SMR 4.72: 95% confidence interval (CI): 1.77-12.6: p=0.007). CONCLUSIONS: The rate of PCI decreased and in-hospital mortality increased immediately after the Japan earthquake disaster in the Tsunami-stricken area. Disorder in hospitals and in the distribution systems after the disaster impacted the clinical care and outcome of STEMI patients.
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Itoh et al. (2014) conducted a cohort in Acute ST-elevation myocardial infarction (STEMI) (n=386). Japan earthquake disaster with massive Tsunami (2011) vs. Pre-disaster period (2010) was evaluated on In-hospital mortality (SMR 4.72, 95% CI 1.77-12.6, p=0.007). The Japan earthquake and Tsunami significantly increased in-hospital mortality among STEMI patients in the stricken area from 7.1% to 23.5% (SMR 4.72; 95% CI 1.77-12.6; p=0.007).
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