A12 - Impact of the 2015 earthquake in hospital admissions at the Tribhuvan University Teaching Hospital: preliminary results

Background: In April 2015, Nepal was hit by a 7.8 magnitude earthquake, causing nearly 9,000 dead and 22,000 injured. The Tribhuvan University Teaching Hospital (TUTH) in Kathmandu received a high share of people affected. Literature on earthquake impact on hospitals is scarce, particularly in the mid and longer term. Methodology: To understand the effect of the earthquake in the functioning of TUTH, we gathered admission data from 1.5 months before to 3 months after the earthquake. We collected sociodemographic and clinical information (ICD-10 codes), and admission and discharge dates of patients. We defined 4 periods: Pre-Earthquake (PREEQ), Acute Earthquake Period (3 weeks after the first shake – EQ1), Post-Acute Earthquake Period (3 weeks after the acute period – EQ2), and Post Earthquake (POSTEQ). We performed descriptive analysis and logistic regression with period as outcome variable, taking sex and diagnosis in consideration. Results: A total of 9615 admissions were included. In EQ1, and compared to PREEQ, the odds of admission due to injury had the highest significant increase compared to other diagnoses (OR= 5.36, p<0.001). There was a significant decrease in the odds of admission of 0-4 age group compared to the 15-49 group (OR=0.68, p<0.01). In EQ2, the odds of being admitted due to respiratory diseases, and pregnancy-related issues were significantly lower relative to PREEQ (OR=0.770, p<0.05; OR=0.78, p<0.05 respectively). Finally, in POSTEQ, the odds were lower for injuries (OR=0.84, p<0.05), pregnancy (OR=0.72, p<0.001), and people aged 50 or more (OR=0.85, p<0.01), relative to PREEQ. Discussion: The higher odds of admission for injuries in the acute period is supported by the literature. The decrease in pregnancy-related admission implies that women’s access to this hospital was reduced. This study supports a conceptual model proposed of hospital needs after a sudden disaster, where trauma emergencies increase in a very short-term, leaving non-trauma emergencies and elective admissions for a post-acute phase. Keywords: earthquake, patient admissions, disaster