Abstract 14670: Did Hurricane Katrina Continue to Affect the Incidence of Acute Coronary Syndromes in New Orleans?
Objective: The goals of our study were to detect any long-term increase in the incidence of acute myocardial infarction (AMI) after Hurricane Katrina and to investigate pertinent contributing factors.
Methods: This was a single center retrospective cohort observational study. Patients admitted with AMI to Tulane University Hospital, in the two years before Katrina and in the three years after the hospital reopened in February, 2006 were identified from hospital medical records. The two groups (pre- and post Katrina) were compared for pre-specified demographic and clinical data.
Results: In the 3-year post-Katrina group, there were 418 confirmed admissions for AMI out of a total census of 21,092 patients (2.0%), as compared to 150 out of a census of 21,079 (0.7%) in the 2-year pre-Katrina group (p<0.0001). The post-Katrina group had a higher prevalence of unemployment (p<0.0001), lack of medical insurance (p<0.001), smokers (p<0.01), medical non-compliance (P<0.0001), first time hospitalizations (p<0.001), local residents rather than visitors or migrants (p<0.0001), history of coronary artery disease (p<0.01), multiple vessel disease (p<0.05), and percutaneous coronary interventions (p<0.0001). More people in the post-Katrina group were single/divorced (p<0.05). The age of onset of AMI decreased from a mean of 62 years pre-Katrina to 59 years post-Katrina (p<0.05). There were no significant differences between the two groups in terms of race, and history of hypertension, diabetes mellitus and chronic renal disease.
Discussion: Our data suggests that chronic stress after natural disasters can significantly impact cardiovascular risk factors such as tobacco abuse and increase medical noncompliance. Katrina led to prolonged loss of employment and insurance, decreased access to preventive health services and an increased incidence of AMI.
Conclusion: We found a three-fold increased incidence of AMI more than three years after Hurricane Katrina compared with two years before Katrina. Notwithstanding the limitations of a single center study, our data are consistent with a highly significant change in the overall health of the population, and supports the need for further study into the health effects of chronic stress after a natural disaster.
- © 2010 by American Heart Association, Inc.