Impact of Hurricane Maria on the mortality of patients admitted to the MICU at the VA Caribbean Healthcare System in Puerto Rico

Objective: This study aims to assess the impact of Hurricane Maria on mortality rates and patient conditions in the Medical Intensive Care Unit (MICU) at the Veterans Affairs Caribbean Healthcare Hospital in San Juan, Puerto Rico (PR). The focus is on the 2 months before and after the hurricane’s landfall. Design: This is a retrospective, transversal study. Setting: The intensive care unit at the Veteran Affairs Caribbean Healthcare System in San Juan, PR. Participants: A total of 202 patients, sampled using a time-defined method, aged 21-90 years, were admitted to the MICU between July 16, 2017, and November 16, 2017. Main outcome measure(s): The primary measure is the mortality rate of MICU patients during the specified period. Secondary measures include the severity of patient conditions and changes in the causes of death, particularly cardiovascular deaths. Results: The overall mortality rate in the MICU did not significantly change following Hurricane Maria. However, there was an increase in cardiovascular-related deaths. In addition, patient conditions showed higher severity post-hurricane, as indicated by Apache II scores, along with prolonged hospital stays and altered admission patterns for specific conditions. Conclusions: While Hurricane Maria did not significantly alter overall mortality rates in the MICU, the increase in cardiovascular deaths and more severe post-hurricane patient conditions underscore the need for enhanced disaster preparedness and response strategies in critical care settings.