title: In the wake of Hurricane Isabel: a prospective study of postevent trauma and injury control strategies.
abstract: Preventing hurricane-related injuries (HRI) has historically centered on the pre-event and event phases of the disaster. To date, no study has focused on injuries occurring during the postevent phase. We examined HRI that occurred after Hurricane Isabel struck a U.S. urban city. HRI presenting 1 week prior to the hurricane were collected from emergency department electronic records. HRI that presented to our level 1 trauma center were prospectively collected for 1 week after the hurricane. Nine hundred seventy-eight patients with possible HRI were identified. Fifty-one patients with trauma directly attributed to the hurricane were used for analysis. The number of HRI occurring before, during, and after the hurricane were 7 (14%), 3 (6%), and 41 (80%), respectively. The majority of HRI (37%) occurred on posthurricane day 1. Head, chest, upper and lower extremities accounted for 9 (18%), 8 (16%), 13 (26%), and 14 (28%) of HRI. More than one third of HRI patients were admitted to the hospital, and 12 (24%) underwent an operation. The average hospital length of stay was 4.7 days. Of our trauma alerts, 75 per cent had an Injury Severity Score (ISS) >8, and 20 per cent had an ISS >15. Tree-related injuries (TRI) accounted for 59 per cent of HRI. Males, ages 50-60, had the highest incidence of injury (63%). Significant injuries occur in the wake of a hurricane. Optimization of disaster preparation must include prevention strategies targeted to the postevent recovery phase of disasters.
authors.affiliation: Division of Trauma Surgery, Department of Surgery, Virginia Commonwealth University Health System, Medical College of Virginia Campus, Richmond, Virginia 23298-0454, USA.
authors.forename: E B
authors.initials: EB
authors.lastname: Gagnon
authors.forename: M B
authors.initials: MB
authors.lastname: Aboutanos
authors.forename: A K
authors.initials: AK
authors.lastname: Malhotra
authors.forename: D
authors.initials: D
authors.lastname: Dompkowski
authors.forename: T M
authors.initials: TM
authors.lastname: Duane
authors.forename: R R
authors.initials: RR
authors.lastname: Ivatury
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004190:Disasters; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D014768:Virginia / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000453:epidemiology*