TY - JOUR PY - 2009// TI - Risk factors of earthquake inpatient death: A case control study JO - Critical care : the Official Journal of the Critical Care Forum A1 - Wen, Jin A1 - Shi, Y. A1 - Li, Yun A1 - Wang, Lili A1 - Cheng, Lan A1 - Gao, Ziyou A1 - Li, Louman SP - R24 EP - R24 VL - 13 IS - 1 N2 - 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

LA - en SN - 1364-8535 UR - http://dx.doi.org/10.1186/cc7729 ID - ref1 ER -