Hurricanes are severe weather events that can disrupt power, water, and transportation systems. These disruptions may be deadly for patients requiring maintenance dialysis. We hypothesized that the mortality risk among patients requiring maintenance dialysis would be increased in the 30 days after a hurricane.

Patients registered as requiring maintenance dialysis in the United States Renal Data System who initiated treatment between January 1, 1997 and December 31, 2017 in one of 108 hurricane-afflicted counties were followed from dialysis initiation until transplantation, dialysis discontinuation, a move to a nonafflicted county, or death. Hurricane exposure was determined as a tropical cyclone event with peak local wind speeds ≥64 knots in the county of a patient’s residence. The risk of death after the hurricane was estimated using time-varying Cox proportional hazards models.

The median age of the 187,388 patients was 65 years (IQR, 53–75) and 43.7% were female. There were 27 hurricanes and 105,398 deaths in 529,339 person-years of follow-up on dialysis. In total, 29,849 patients were exposed to at least one hurricane. Hurricane exposure was associated with a significantly higher mortality after adjusting for demographic and socioeconomic covariates (hazard ratio, 1.13; 95% confidence interval, 1.05 to 1.22). The association persisted when adjusting for seasonality.

Patients requiring maintenance dialysis have a higher mortality risk in the 30 days after a hurricane.

飓风是一种严重的天气事件，可能会破坏电力、水和运输系统。这些干扰对于需要维持性透析的患者来说可能是致命的。我们假设需要维持性透析的患者的死亡风险在飓风过后 30 天内会增加。

1997 年 1 月 1 日至 2017 年 12 月 31 日期间，在美国肾脏数据系统中登记为需要维持性透析的患者，在 108 个受飓风影响的县之一开始接受治疗，从开始透析到移植、透析停止、转移到未受飓风影响的县进行随访。县，或死亡。飓风暴露被确定为患者居住县当地峰值风速≥64节的热带气旋事件。使用时变 Cox 比例风险模型估算飓风后的死亡风险。

187,388 名患者的中位年龄为 65 岁（IQR，53-75），其中 43.7% 为女性。在 529,339 人年的透析随访中，发生了 27 次飓风，105,398 人死亡。总共有 29,849 名患者遭受了至少一场飓风的袭击。调整人口和社会经济协变量后，飓风暴露与死亡率显着升高相关（风险比，1.13；95% 置信区间，1.05 至 1.22）。在根据季节性进行调整后，这种关联仍然存在。

需要维持性透析的患者在飓风过后 30 天内死亡风险较高。