Assessment of earthquake casualties and comparison of accuracy of five injury triage methods: evidence from a retrospective study

ObjectiveThe use of an injury triage method among earthquake injury patients can facilitate the reasonable allocation of resources, but the various existing injury triage methods need further confirmation. This study aims to assess the accuracy of several injury triage methods, namely, the Simple Triage and Rapid Treatment (START) technique; CareFlight Injury Triage (CareFlight); Rapid Emergency Medicine Score (REMS); Triage Revised Trauma Score (T-RTS) and Triage Early Warning Score (TEWS), based on their effects on earthquake injury patients.DesignData in the Huaxi Earthquake Casualty Database were analysed retrospectively.SettingThis study was conducted in China.ParticipantsData on 29 523 earthquake casualties were separately evaluated using the START technique, CareFlight, REMS, T-RTS and TEWS, with these being the five types of injury triage studied.Primary outcome measureThe receiver operating characteristic (ROC) curves for the five injury triages were calculated based on hospital deaths, injury severity scores greater than 15 points, and whether casualties stayed in the intensive care unit.ResultsThe ROC curve areas of the START technique, CareFlight, REMS, T-RTS and TEWS were 0.750, 0.737, 0.835, 0.736 and 0.797, respectively. Among the five injury triages, the most accurate in predicting hospital deaths was REMS, with an average area under the curve (AUC) of 0.835, with this due to the inclusion of more evaluation indicators.ConclusionAll methods had an effect on the triage of earthquake mass casualties. Among them, the REMS injury triage method had the largest AUC of the five triage methods. Except for REMS, no obvious difference was found in the effect of the other four injury triage methods.

Study on Assessment Method of Earthquake Casualties Based on Spatial Reasoning of Similarly Historical Cases

<p><strong> </strong>Earthquake is one of the most serious natural disasters for human survival. Once a destructive earthquake occurs, it often leads to huge losses. However, in the early days after the earthquake, it was difficult to quickly obtain disaster information due to the interruption of traffic, electricity, and communications. Therefore, damage assessment based on similarly historical cases rapidly in access to limited disaster data situation is effective support for analysis disaster and making disaster relief decision. In this study, earthquake disaster statistics with a magnitude of 4.0 or above and casualties in China from 2000 to 2013 were selected as historical cases. The number of earthquake casualties was used as an evaluation index, and the earthquake magnitude, focal depth and time of earthquake are selected as disaster indicators. A similarity assessment model based on Manhattan distance was used to evaluate the similarity of historical cases, and the collection of historical cases that participated in the assessment were screened.And then considering the spatial correlation between historical cases and current disasters, an earthquake disaster assessment model based on spatial reasoning of similarly historical cases would be established. Then the Yushu earthquake in Qinghai in 2010, the Lushan earthquake in Sichuan in 2013, and the Ludian earthquake in Yunnan in 2014 were selected as cases for accuracy verification by comparing the actual number of casualties. The result shows that: (1) For the three verification cases, the best evaluation accuracy of the  model is above 95%, indicating that the method has certain feasibility and applicability in the assessment of earthquake casualties;(2) The accuracy of the disaster assessment is related to the number of participating cases. When there are more than two participating cases, the accuracy of the model assessment decreases steadily with the increase in the number of participating cases. When the number of participating cases is 3 ~ 4, the evaluation accuracy of the model is the best. The method of this study is low cost, high efficiency, timeliness strong, simple, less constraints and easy to implement. It has certain practical value and promotion prospects in disaster assessment.</p>

The Quick Assessment Model of Casualties for Asia based on the Vulnerability of Earthquake

In order to make a scientific emergency strategic decision after an earthquake, casualties need to be estimated rapidly. Asia is the most earthquake-prone continent in the world. In this paper, by spatial statistic and regressive analysis of historical Asian earthquake data from 1990 to 2012, vulnerability curves portraying the empirical relationship between the magnitude of an earthquake event and the casualty rate caused by it were created for countries of six-groups and the Quick Assessment Model of Earthquake Casualties for Asia (QAMECA) was developed. The casualty rate was defined as the ratio of the sum of injuries and deaths in an earthquake to the number of people living in the earthquake-affected region. Thirty-one earthquake events from 2013 to 2016 were used to validate this model, and the validation results were good with actual casualties of twenty-one were within the range estimated by the model and the biases of eight out of ten were less than one hundred percent. The two input parameters of QAMECA were magnitude and location of epicenter of an earthquake and earthquake casualties can be estimated immediately after earthquake has occurred. As a consequence, QAMECA can be used to estimate earthquake casualties for Asian countries and aid decision making in international emergency relief in the future.