Citation

Wen J, Shi Y, Li Y, Wang L, Cheng L, Gao Z, Li L. Crit. Care 2009; 13(1): R24.

Copyright

(Copyright © 2009, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/cc7729

PMID

19243616

PMCID

PMC2688142

Abstract

INTRODUCTION: At 2:28 p.m. on May 12, 2008, a devastating earthquake measuring 8.0 on the Richter scale hit Wenchuan County, Sichuan Province in southwest China, and resulted in the deaths of thousands of people. To date, few epidemiological studies have been conducted on the determinants of the mortality of hospitalized earthquake patients. This paper is aimed at identifying the contributing factors of mortality, and providing a clinical reference for the management of those injured in earthquakes. METHODS: A hospital-based case-control study was conducted. Cases included all deaths (number of cases = 36) due to earthquake injuries in West China Hospital. Controls were the quake survivors from the same hospital by 1:4 matching on sex and age. Data sources included death certificates and medical records. A conditional logistic regression was performed to assess the odds ratio of variables used in the study. A chi-squared test for trend was performed to reveal the possible relationship between factor (variable) number and case fatality. RESULTS: People with a severe traumatic brain injury (TBI) had the greatest risk of death (adjusted odds ratio (OR) = 253.3, 95% confidence interval (CI): 8.9 to 7208.6), followed by patients with multiple system organ failure (MSOF) (adjusted OR = 87.8, 95% CI: 3.9 to 1928.3). Prior major disease and infection significantly increased the risk of earthquake related death (adjusted OR = 14.9, 95% CI: 1.9 to 119.0; adjusted OR = 13.7, 95% CI: 1.8 to 103.7; respectively). The case fatality increased as the factor numbers raised. CONCLUSIONS: Severe TBI, infection, MSOF, and prior major disease are the significant determinants of earthquake-related inpatient death in the 2008 Wenchuan earthquake. Future research with a large sample including macro- and micro-level factors is needed.

Language: en