Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 18;14(7):e0220016.
doi: 10.1371/journal.pone.0220016. eCollection 2019.

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

Maria Moitinho de Almeida  1 , Joris Adriaan Frank van Loenhout  1 , Sunil Singh Thapa  2 , K C Kumar  3 , Benjamin-Samuel Schlüter  1 , Ravikant Singh  4 , Xavier Banse  5 , Dan Putineanu  5 , Deepak Prakash Mahara  2 , Debarati Guha-Sapir  1
Affiliations

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

Maria Moitinho de Almeida et al. PLoS One. .

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Distribution of delay in presentation.
Delay in presentation was calculated as the number of days between the first earthquake on April 25th and the date of admission.
Fig 2
Fig 2. Distribution of length of hospital stay.
Length of hospital stay corresponds to the number of days between the date of admission and date of discharge.
Fig 3
Fig 3. Frequency of primary diagnoses of admitted earthquake victims.
Diagnoses with a relative frequency higher than 0.5% are shown, the remaining are aggregated under “All other diagnoses”.
See this image and copyright information in PMC

References

    1. Burton I, Kates R, White G, Clarke L, Coppola D, Crandall W, et al. UNISDR Terminology on Disaster Risk Reduction (2009). International Strategy for Disaster Reduction. 2015.
    1. Guha-Sapir D. EM-DAT: The OFDA/CRED International Disaster Database Brussels, Belgium http://emdat.be/.
    1. World Health Organization. Earthquakes—Technical Hazard Sheet—Natural Disaster Profile http://www.who.int/hac/techguidance/ems/earthquakes/en/
    1. Doocy S, Daniels A, Packer C, Dick A, Kirsch TD. The human impact of earthquakes: a historical review of events 1980–2009 and systematic literature review. PLoS Curr. 2013;5. - PMC - PubMed
    1. Noji EK. The public health consequences of disasters. Prehosp Disaster Med. 2000;15(4):147–57. - PubMed

Publication types

LinkOut - more resources