title: Impact of tornadoes on hospital admissions for acute cardiovascular events.
abstract: BACKGROUND
  There is a paucity of data describing cardiovascular events after tornado outbreaks. We proposed to study the effects of tornadoes on the incidence of cardiovascular events at a tertiary care institution.
  
  
  METHODS
  Hospital admission records from a single center situated in a tornado-prone area three months before and after a 2013 tornado outbreak were abstracted. To control for seasonal variation, we also abstracted data from the same period of the prior year (control). Hospital admissions for cardiovascular events (CVEs) including acute myocardial infarction, stroke and venous thromboembolism (VTE) were summated by zip codes, and compared by time period.
  
  
  RESULTS
  There were 22,607 admissions analyzed, of which 6,705 (30%), 7,980 (35%), and 7,922 (35%) were during the pre-tornado, post-tornado, and control time frames, respectively. There were 344 CVE in the controls, 317 CVE in pre-tornado and 364 CVEs in post tornado periods. There was no difference in the prevalence of CVE during the post-tornado season compared with the control (PPR=1.05 95% CI: 0.91 to 1.21, p=0.50) or the pre-tornado season (PPR=0.96, 95% CI: 0.83 to 1.21, p=0.63).
  
  
  CONCLUSIONS
  In conclusion, tornado outbreaks did not increase the prevalence of cardiovascular events. In contrast to the effect of hurricanes, implementation of a healthcare policy change directed toward the early treatment and prevention of cardiovascular events after tornadoes does not seem warranted.
authors.affiliation: Vascular Medicine Program, Cardiovascular Section, Department of Medicine, University Of Oklahoma, United States.
authors.forename: Federico
authors.initials: F
authors.lastname: Silva-Palacios
authors.affiliation: Vascular Medicine Program, Cardiovascular Section, Department of Medicine, University Of Oklahoma, United States. Electronic address: Ana-Casanegra@ouhsc.edu.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Casanegra
authors.affiliation: School of Meteorology, University of Oklahoma, United States.
authors.forename: Alan
authors.initials: A
authors.lastname: Shapiro
authors.affiliation: Hematology and Oncology Section, Department of Medicine, University of Oklahoma, United States.
authors.forename: Minh
authors.initials: M
authors.lastname: Phan
authors.affiliation: Cardiovascular Section, Department of Medicine, University of Oklahoma, United States.
authors.forename: Beau
authors.initials: B
authors.lastname: Hawkins
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma, United States.
authors.forename: Ji
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma, United States.
authors.forename: Julie
authors.initials: J
authors.lastname: Stoner
authors.affiliation: Vascular Medicine Program, Cardiovascular Section, Department of Medicine, University Of Oklahoma, United States.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Tafur
mesh_terms: D000208:Acute Disease; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009825:Oklahoma / Q000453:epidemiology; D012307:Risk Factors; D055869:Tornadoes / Q000401:mortality / Q000706:statistics & numerical data*
keywords: Coronary artery disease; Stroke; Tornado; Venous thromboembolism