{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T02:11:43Z","timestamp":1762049503124,"version":"build-2065373602"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1935789322000635_as1\">\n\t    <jats:title>Objectives:<\/jats:title>\n\t    <jats:p>Patients with end stage kidney disease (ESKD) are at higher risk for increased mortality and morbidity due to disaster-related disruptions to care. We examine effects of Hurricanes Irma and Maria on access to dialysis care for US Department of Veterans Affairs (VA) ESKD patients in Puerto Rico.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1935789322000635_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>A retrospective, longitudinal cohort study was conducted among VA patients with at least 1 dialysis-related encounter between September 6, 2016, and September 5, 2018. The annual number of dialysis encounters, visits to an emergency department (ED), and the number of deaths pre- and post-hurricanes were compared. A random effects logistic regression model for correlated binary outcomes was fitted for predictors of mortality. Chi-square tests were for differences between pre- and post-hurricane visits.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1935789322000635_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>The number of ED visits increased in post-hurricane period (1172 [5.7%] to 1195 [6.6%]; <jats:italic>P<\/jats:italic> &lt; 0.001). ESKD-related ED visits increased from 200 (0.9%) to 227 (1.3%) (<jats:italic>P<\/jats:italic> &lt; 0.05). Increase in mortality was associated with age (OR = 1.66; CI: 1.23-2.17), heart failure (OR = 2.07; CI: 1.26-3.40), chronic pulmonary disease (OR = 3.26; CI: 1.28-8.28), and sepsis (OR = 3.16; CI: 1.89-5.29).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1935789322000635_as4\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>There was an increase in dialysis services at the San Juan VA Medical Center post-Irma\/Maria, and access to dialysis care at the non-VA clinics was limited. The role of VA dialysis centers in providing care during disasters warrants further investigation.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/dmp.2022.63","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T09:05:52Z","timestamp":1651827952000},"source":"Crossref","is-referenced-by-count":3,"title":["Dialysis Care for US Military Veterans in Puerto Rico during the 2017 Atlantic Hurricane Season"],"prefix":"10.1017","volume":"17","author":[{"given":"Lilia R.","family":"Lukowsky","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aram","family":"Dobalian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamyar","family":"Kalantar-Zadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Der-Martirosian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,5,6]]},"reference":[{"key":"S1935789322000635_ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000494580"},{"key":"S1935789322000635_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.02.725"},{"key":"S1935789322000635_ref1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10181014"},{"key":"S1935789322000635_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.01.023"},{"key":"S1935789322000635_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/81.3.543"},{"key":"S1935789322000635_ref21","unstructured":"21. Kuss, O. How to use SAS for logistic regression with correlated data. Proceedings of the 27th Annual SAS Users Group International Conference; 2002. 2002. https:\/\/support.sas.com\/resources\/papers\/proceedings\/proceedings\/sugi27\/p261-27.pdf"},{"key":"S1935789322000635_ref17","doi-asserted-by":"publisher","DOI":"10.1109\/THS.2018.8574120"},{"key":"S1935789322000635_ref18","unstructured":"18. FEMA. 2017 Hurricane Season FEMA After-Action Report. Published July 12, 2018. Accessed April 7, 2022. https:\/\/www.fema.gov\/sites\/default\/files\/2020-08\/fema_hurricane-season-after-action-report_2017.pdf"},{"key":"S1935789322000635_ref27","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2018010086"},{"key":"S1935789322000635_ref6","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03481006"},{"key":"S1935789322000635_ref29","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.12.004"},{"key":"S1935789322000635_ref2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.03.017"},{"key":"S1935789322000635_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X12000945"},{"key":"S1935789322000635_ref8","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.5"},{"key":"S1935789322000635_ref22","doi-asserted-by":"publisher","DOI":"10.6339\/JDS.2013.11(4).1195"},{"key":"S1935789322000635_ref5","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00530107"},{"key":"S1935789322000635_ref15","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004090748"},{"key":"S1935789322000635_ref19","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.304198"},{"key":"S1935789322000635_ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s11111-020-00338-6"},{"key":"S1935789322000635_ref14","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.185"},{"key":"S1935789322000635_ref26","first-page":"12","article-title":"Evacuating, treating, and tracking people on dialysis: lessons learned from the 2017 hurricane season","volume":"1","author":"Hick","year":"2018","journal-title":"Exchange"},{"key":"S1935789322000635_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32591-6"},{"key":"S1935789322000635_ref24","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X14000715"},{"key":"S1935789322000635_ref12","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2018.1456464"},{"key":"S1935789322000635_ref11","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S46643"},{"key":"S1935789322000635_ref7","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03971106"},{"key":"S1935789322000635_ref13","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012060595"},{"key":"S1935789322000635_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/2150132719863599"},{"key":"S1935789322000635_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2018.142"}],"container-title":["Disaster Medicine and Public Health Preparedness"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1935789322000635","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T15:18:49Z","timestamp":1675264729000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1935789322000635\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,6]]},"references-count":29,"alternative-id":["S1935789322000635"],"URL":"https:\/\/doi.org\/10.1017\/dmp.2022.63","relation":{},"ISSN":["1935-7893","1938-744X"],"issn-type":[{"type":"print","value":"1935-7893"},{"type":"electronic","value":"1938-744X"}],"subject":[],"published":{"date-parts":[[2022,5,6]]},"article-number":"e187"}}