Background/Purpose: On September 20, 2017, Puerto Rico was devastated by Hurricane Maria causing severe damage to the Island infrastructure and essential services such as electricity, water supply, communications, and access to health care. Catastrophic natural disasters can have negative effects on the health and outcome of patients with chronic diseases. Thus, we sought to determine the impact on disease activity and patient-reported outcomes of health in a group of Puerto Ricans with SLE.

Methods: Hispanics from Puerto Rico participating in PROFILE, a longitudinal multiethnic cohort, were studied. Disease activity (per Systemic Lupus Erythematosus Activity Index [SLEDAI]) and patient-reported outcomes of health (per Short Form-36 [SF-36]) were examined before and after Hurricane Maria. SF-36 scores were transformed into a 0-100 scale in which higher scores represent better health. Patients seen between October 2017 and April 2018 were included in the analysis. SLEDAI and SF-36 scores were compared before and after Hurricane Maria using paired t test and Wilcoxon signed rank test, as appropriate.

Results: A total of 127 patients had their scheduled annual visits during the study period; 90 patients were seen, 15 missed their scheduled visit, 15 migrated to continental United States, 6 were unable to reach, and 1 died. Among patients seen at their study visits, 81 (90%) were women and the mean age was 45.3±11.7 years. Forty-four percent had private healthcare insurance, 39% had public insurance, 14% had Medicare, and 2% had no insurance coverage. No significant changes were seen for disease activity or overall SF-36 scores before and after Hurricane Maria. However, differences were observed for some mental and physical health components of the SF-36. Significantly lower scores were seen after Hurricane Maria in the mental health (60.2±24.9 vs. 65.2±22.6, p=0.011) and bodily pain (43.6±31.1 vs. 50.8±30.8, p=0.011) components when compared to the visit prior to the hurricane. Similarly, a tendency was observed for lower scores in the social functioning (59.4±31.9 vs. 65.0±29.0, p=0.051) and role emotional (67.7±29.3 vs. 73.1±26.7, p=0.096) components.

Conclusion: In this cohort of SLE patients from Puerto Rico, 71% were seen at their scheduled study visits after Hurricane Maria. Among these patients, worse patient-reported outcomes of health were seen for some mental and physical components of the SF-36. No differences were observed for disease activity. Nonetheless, longer follow up is needed to determine the long-term impact of Hurricane Maria on this cohort of SLE patients.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-hurricane-maria-on-a-cohort-of-systemic-lupus-erythematosus-patients-from-puerto-rico/