@article{ref1,
title="Survival and cost analysis of fatalities of the Kobe earthquake in Japan",
journal="Prehospital emergency care",
year="2004",
author="Aoki, Noriaki and Nishimura, Akiyoshi and Pretto, Ernesto A. and Sugimoto, Katsuhiko and Beck, J. Robert and Fukui, Tsuguya",
volume="8",
number="2",
pages="217-222",
abstract="OBJECTIVES: The authors investigated the dying patterns, and cause and preventability of deaths in a major earthquake disaster, and estimated the cost needed to enhance emergency medical services (EMS) response to prevent &quot;unnecessary&quot; deaths. METHODS: The authors reviewed autopsy data in the Hanshin-Awaji (Kobe) earthquake of 1995. A survival analysis was performed to determine the time course and pattern of dying of these deaths. A cost analysis to estimate acceptable cost for EMS to reduce fatalities was also performed. Potentially salvageable life-years based on expected life-years among fatalities were calculated and used to simulate an acceptable cost for an enhanced EMS disaster response. RESULTS: The authors analyzed 5,411 fatalities. More than 80% of these patients died within three hours. There were statistically significant differences in survival/dying patterns among causes of death. Thirteen percent of victims experienced a protracted death, which could have been prevented with earlier medical or surgical intervention. The monetary cost of these lost lives was estimated at approximately 600 million US dollars. CONCLUSIONS: Survival analysis revealed a significant population of potentially salvageable patients if more timely and appropriate medical intervention had been available immediately after the earthquake. Based on our cost analysis, and assuming a 1% annual probability of an earthquake and a 30% enhanced lifesaving capability of the EMS effort, approximately $ million dollars annually could be a reasonable expenditure to achieve the goal of reducing preventable deaths in disasters.<p /><p>Language: en</p>",
language="en",
issn="1090-3127",
doi="",
url="http://dx.doi.org/"
}