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Prehosp Emerg Care. 2004 Apr-Jun;8(2):217-22.

Survival and cost analysis of fatalities of the Kobe earthquake in Japan.

Author information

1
School of Health Information Sciences, University of Texas Health Science Center-Houston, Houston, Texas 77030, USA. noriaki.aoki@uth.tmc.edu

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 "unnecessary" 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.

PMID:
15060860
[Indexed for MEDLINE]
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