title: Impact of a large-scale natural disaster on patients with chronic obstructive pulmonary disease: the aftermath of the 2011 Great East Japan Earthquake.
abstract: BACKGROUND
  A large-scale natural disaster may exacerbate chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD). The aftermath of a natural disaster can include poor access to medication, medical equipment, and medical supplies. Little is known about the impact on patients with COPD.
  
  
  METHODS
  A retrospective cohort study was conducted at a regional medical center in Ishinomaki, the area affected most severely by the Great East Japan Earthquake in 2011. The study was performed 6 months after the disaster. The characteristics, clinical courses, and outcomes of COPD patients hospitalized after emergency visits during the study period were investigated and compared.
  
  
  RESULTS
  One hundred patients (112 episodes) were identified. Within a few days after the disaster, patients undergoing oxygen therapy at home came to the hospital to receive oxygen. In the subacute phase (from the third to the fifth week), the number of hospitalizations due to COPD exacerbations was significantly increased compared to the numbers observed before the earthquake (p<0.05). On admission, COPD patients reported significantly reduced participation in the activities of daily living (ADLs) after as compared to before the disaster. The incidence of cases of exacerbated COPD normalized 6 weeks after the earthquake.
  
  
  CONCLUSIONS
  The large-scale natural disaster that hit Japan in 2011 had a serious negative impact on the clinical outcomes of COPD patients in the disaster-affected area.
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki 986-8522, Japan. skoba-thk@umin.ac.jp
authors.forename: Seiichi
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hanagama
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Yamanda
authors.forename: Hikari
authors.initials: H
authors.lastname: Satoh
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Tokuda
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Ueda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Masaru
authors.initials: M
authors.lastname: Yanai
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D055866:Earthquakes; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors