2007 San Diego Wildfire Impact on the Emergency Departments of University of California, San Diego Hospital System

Background/Purpose: The goal of this study was to assess the impact of the 2007 San Diego Wildfires, and the resulting change in air quality, on patient volume and chief complaints in the emergency department (ED). Methods: A structured multicenter retrospective review was performed of a database of all patients presenting to the ED of an academic urban and a suburban hospital for a six day period before and after the start of the firestorm. Charts were abstracted for demographics, chief complaints, past medical history, fire related injuries and disposition status. 2.5 micron Particulate Matter (PM2.5) levels were calculated as a measure of air quality. Differences by period were assessed with a t- test for continuous variables and a chi-square test for categorical variables, alpha = p>0.05. Results/Outcomes: ED Volume decreased by 5.8% for the period following the fires. A rapid rise in PM2.5 levels coincided with the onset of the fires. Following the fires, increases were noted in rates of admissions (19.8% vs. 15.2%) and LWBS (4.6% vs. 2.3%). Patients with significant cardiac or pulmonary histories were no more likely to present to the ED during the firestorm. There was an increase in patients presenting with a chief complaint of shortness of breath (6.5% vs. 4.2% p=0.028) following the fires. Conclusions: Admission and LWBS rates increased despite decreased ED volume during the firestorm. A sudden decline in air quality did not influence the ED utilization rate of patients with significant cardiac and pulmonary morbidity.