Journal Article

Clinical and demographic profile of admitted victims in a tertiary hospital after the 2015 earthquake in Nepal

Singh, Ravikant, Banse, Xavier, Schlüter, Benjamin-Samuel, Mahara, Deepak Prakash, van Loenhout, Joris Adriaan Frank, Thapa, Sunil Singh, Putineanu, Dan, Kumar, K. C., Moitinho de Almeida, Maria, Guha-Sapir, Debarati

2019

Overview

In 2015, an earthquake killing 9,000 and injuring 22,000 people hit Nepal. The Tribhuvan University Teaching Hospital (TUTH), a reference tertiary hospital, was operational immediately after the earthquake. We studied the profile of earthquake victims admitted in TUTH and assessed what factors could influence hospital length of stay. An earthquake victim dataset was created based on patient records, with information on sex, age, date of admission and discharge, diagnosis, and surgical intervention. We performed an initial descriptive overview of the earthquake victims followed by a time-to-event analysis to compare length of hospital stay in different groups, using log rank test and cox regression to calculate Hazard Ratios. There were in total 501 admitted victims, with the peak of admissions occurring on the fifth day after the earthquake. About 89% had injury as main diagnosis, mostly in lower limbs, and 66% of all injuries were fractures. Nearly 69% of all patients underwent surgery. The median length of hospital stay was 10 days. Lower limb and trunk injuries had longer hospital stays than injuries in the head and neck (HR = 0.68, p = 0.009, and HR = 0.62 p = 0.005, respectively). Plastic surgeries had longer hospital stays than orthopaedic surgeries (HR = 0.57 p = 0.006). Having a crush injury and undergoing an amputation also increased time to discharge (HR = 0.57, p = 0.013, and HR = 0.65 p = 0.045 respectively). Hospital stay was particularly long in this sample in comparison to other studies on earthquake victims, indirectly indicating the high burden TUTH had to bear to treat these patients. To strengthen resilience, tertiary hospitals should have preparedness plans to cope with a large influx of injured patients after a large-scale disaster, in particular for the initial days when there is limited external aid.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adult / Amputation / Biology and Life Sciences / Care and treatment / Child / Child, Preschool / Chronic illnesses / Demographics / Demography / Diagnosis / Disaster management / Disaster victims / Disaster Victims - history / Disaster Victims - statistics & numerical data / Disasters / Discharge / Earthquakes / Emergency preparedness / Epidemiology / Female / Fractures / Head and neck / Head injuries / Health services / History, 21st Century / Hospital admission and discharge / Hospitalization / Humans / Infant / Infant, Newborn / Injuries / Male / Medical Records / Medicine and Health Sciences / Middle Aged / Morbidity / Nepal - epidemiology / Orthopedics / Patients / Pediatrics / People and Places / Plastic surgery / Proportional Hazards Models / Rank tests / Regression analysis / Seismic activity / Surgery / Survival analysis / Teachers / Teaching hospitals / Tertiary Care Centers / Trauma / Young Adult