title: Health status among emergency department patients approximately one year after consecutive disasters in New York City.
abstract: OBJECTIVE
  Emergency department (ED) patients with disaster-related experiences may present with vague symptoms not clearly linked to the event. In 2001, two disasters in New York City, the World Trade Center disaster (WTCD) and the subsequent American Airlines Flight 587 crash, presented an opportunity to study long-term consequences of cumulative disaster exposure (CDE) on health-related quality of life (HRQOL) among ED patients.
  
  
  METHODS
  From July 15 to October 30, 2002, a systematic sample of stable, adult patients from two EDs in New York City were enrolled. Participants completed a self-administered questionnaire. The Short Form 36 (SF-36) was used to assess overall health status. Bivariate analyses were conducted to identify individual correlates of worsening health status. Multivariate regression was performed to identify the association between various factors and overall health status, while controlling for relevant sociodemographic variables.
  
  
  RESULTS
  Four hundred seventy-one patients (54.6% female) participated. The participation rate was 73.4%. One hundred sixty-one participants (36%) reported direct, indirect, or occupational exposure to the WTCD; 55 (13.3%) had direct, indirect, or occupational exposure to the plane crash; 33 (8.1%) had both exposures. In separate multivariate models, CDE predicted lower SF-36 scores for general health (p < 0.0096), mental health (p < 0.0033), and bodily pain (p < 0.0046).
  
  
  CONCLUSIONS
  In the year following mass traumatic events, persons with CDE had lower overall health status than those with one or no disaster exposure. Clinicians should consider the impact that traumatic events have on the overall health status of ED patients in the wake of consecutive disasters.
authors.affiliation: Boston University School of Medicine, Department of Emergency Medicine, Boston Medical Center, Boston, MA 02118, USA. william.fernandez@bmc.org
authors.forename: William George
authors.initials: WG
authors.lastname: Fernandez
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.forename: Jeff
authors.initials: J
authors.lastname: Miller
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ahern
authors.forename: William
authors.initials: W
authors.lastname: Chiang
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Kennedy
authors.forename: Joanna
authors.initials: J
authors.lastname: Garritano
mesh_terms: D000328:Adult; D000401:Aircraft; D003430:Cross-Sectional Studies; D004190:Disasters / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology; D016584:Panic Disorder / Q000453:epidemiology; D012008:Recurrence; D012044:Regression Analysis; D047851:September 11 Terrorist Attacks / Q000706:statistics & numerical data; D017678:Sex Distribution; D012959:Socioeconomic Factors