Natural Disasters in the Americas, Dialysis Patients, and Implications for Emergency Planning: A Systematic Review

Natural Disasters in the Americas, Dialysis Patients, and Implications for Emergency Planning: A Systematic Review

SYSTEMATIC REVIEW — Volume 17 — June 11, 2020

Rashida S. Smith, MPH1; Robert J. Zucker, MPH1; Rosemary Frasso, PhD, CPH1 (View author affiliations)

Suggested citation for this article: Smith RS, Zucker RJ, Frasso R. Natural Disasters in the Americas, Dialysis Patients, and Implications for Emergency Planning: A Systematic Review. Prev Chronic Dis 2020;17:190430. DOI: http://dx.doi.org/10.5888/pcd17.190430external icon.

PEER REVIEWED

On This Page

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables
• Appendix

Summary

What is already known on this topic?

Natural disasters can readily disrupt dialysis services, potentially resulting in hospitalizations and death among dialysis patients.

What is added by this report?

Disasters have direct and indirect effects on dialysis patients. Lack of electricity, clean water, and transportation, and closure of dialysis centers can disrupt dialysis care, lead to missed dialysis sessions, and increase the number of hospitalizations and use of the emergency department.

What are the implications for public health practice?

Mitigating the impacts of disasters on dialysis patients requires coordination among health professionals, carefully designed emergency preparedness plans, and education and training of all involved.

Abstract

Introduction

Natural hazards are elements of the physical environment caused by forces extraneous to human intervention and may be harmful to human beings. Natural hazards, such as weather events, can lead to natural disasters, which are serious societal disruptions that can disrupt dialysis provision, a life-threatening event for dialysis-dependent people. The adverse outcomes associated with missed dialysis sessions are likely exacerbated in island settings, where health care resources and emergency procedures are limited. The effect of natural disasters on dialysis patients living in geographically vulnerable areas such as the Cayman Islands is largely understudied. To inform predisaster interventions, we systematically reviewed studies examining the effects of disasters on dialysis patients and discussed the implications for emergency preparedness in the Cayman Islands.

Methods

Two reviewers independently screened 434 titles and abstracts from PubMed, Scopus, CINAHL, and Cochrane Library. We included studies if they were original research articles published in English from 2009 to 2019 and conducted in the Americas.

Results

Our search yielded 15 relevant articles, which we included in the final analysis. Results showed that disasters have both direct and indirect effects on dialysis patients. Lack of electricity, clean water, and transportation, and closure of dialysis centers can disrupt dialysis care, lead to missed dialysis sessions, and increase the number of hospitalizations and use of the emergency department. Additionally, disasters can exacerbate depression and lead to posttraumatic stress disorder among dialysis patients.

Conclusion

To our knowledge, this systematic review is the first study that presents a synthesis of the scientific literature on the effects of disasters on dialysis populations. The indirect and direct effects of disasters on dialysis patients highlight the need for predisaster interventions at the patient and health care system levels. Particularly, educating patients about an emergency renal diet and offering early dialysis can help to mitigate the negative effects of disasters.