Did the Critical Care Patterns of Dialysis Changed during Hurricane Sandy in NYS?

Introduction: Flooding and consequent power outage during Hurricane Sandy not only affected people with chronic diseases, but also had significant impact on electricity-dependent diseases, such as dialysis. However, few research evaluated the critical care use patterns of dialysis after Sandy. This study assessed and compared the changes of emergency department (ED) visits and hospital admissions due to dialysis after Hurricane Sandy and also if sociodemographic interacted with Hurricane Sandy on dialysis.

Methods: Immediate Hurricane Sandy period was defined by FEMA as 10/28/2012 – 11/9/2012. The affected areas included the areas categorized as evacuation zones or Hurricane storm surge zones in five borough NYC counties, Nassau, Suffolk, and Westchester. The rests of the areas in these eight counties were the control areas. Additionally, pre-Sandy period (2001-2011) was also used as a control for pre-/post-Sandy comparison to control county-level socio-demographics. Poisson Negative Binomial model was used to compare service utilization during the storm year with prior years among affected and non-affected areas.

Results: Overall, there were large and significantly increased risks in dialysis ED visits (RR: 2.90, 95% CI 2.24-3.75) and hospitalization for dialysis (RR: 1.29, 95% CI 1.15-1.46) in the storm zone during Hurricane Sandy. The ED visits of dialysis also increased in the non-storm zone (RR: 2.34, 95% CI 1.83-2.98) after Sandy. The peak of dialysis ED visits occurred one day after the extensive power outage in all affected counties. Almost all sociodemographic groups had significantly increased risks of dialysis. People with Medicare and other insurance had significantly increased risks of dialysis ED visits after Hurricane Sandy compared to Medicaid and private insurance. Other race than white and black had the highest risk.

Conclusion: Both Dialysis ED visits and hospital admissions after Hurricane Sandy significantly increased. Generally, the effects of Hurricane Sandy impacted all sociodemographic groups.