The 2015 and 2016 Terrorist Attacks in France: What Impact Did They Have on Hospitalizations for Cardiovascular Disease?
Introduction: In 2015 and 2016, France experienced three waves of terrorist attacks on its territory of unprecedented scale. The nature and violence of these attacks, along with the continuous media coverage that followed, led to increased levels of anxiety and stress among the population, including those not directly exposed to the attacks. However, stress is a factor that contributes to the onset of certain cardiovascular diseases. The objective was to study, at the national and regional levels, the short-term impact of the 2015 and 2016 attacks on hospitalizations for cardiovascular diseases. Methods: Hospitalization data were extracted from the PMSI-MCO database from 2009 to 2016. Complete hospitalizations with a primary diagnosis of acute coronary syndrome (ACS), stroke, or heart failure (HF) were selected. The daily number of hospitalizations by cause and by location (Île-de-France/outside Île-de-France and Alpes-Maritimes/outside Alpes-Maritimes) was analyzed using generalized additive Poisson models, adjusted for short-term variations, seasonal variations, and long-term trends. The increase in hospitalizations was modeled using cyclic splines for the days surrounding the attacks. Results: In the 15 days following the attacks, the crude number of hospitalizations for stroke and HF was higher than the average number of hospitalizations during the same periods in other years of the study. This trend was not observed for hospitalizations for ACS. These differences disappeared after adjusting for short-, medium-, and long-term trends. Increases in the risk of hospitalization within 15 days of the attacks were less than 6% and not statistically significant, regardless of the condition, the attack episode, or the geographic area studied. Conclusion: Our study did not identify a short-term increase in hospitalizations for cardiovascular diseases following the terrorist attacks of 2015 and 2016. Nevertheless, the longer-term effects on incidence and mortality will need to be assessed.
Author(s): Chatignoux E, Gabet A, Moutengou E, Pirard P, Motreff Y, Bonaldi C, Olie V
Publishing year: 2017
Pages: 552-8
Weekly Epidemiological Bulletin, 2017, n° 26, p. 552-8
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