Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study.
Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study.
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DOI：
10.1136/bmj-2021-065653
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发表时间：
2021-11-24
影响因子：
105.7
通讯作者：
Wellenius, Gregory A.
中科院分区：
文献类型：
--
作者：
Sun, Shengzhi;Weinberger, Kate R.;Nori-Sarma, Amruta;Spangler, Keith R.;Sun, Yuantong;Dominici, Francesca;Wellenius, Gregory A.
在美国本土有健康保险的成年人中，量化环境热量与因任何原因和因特定原因就诊急诊科（艾德）之间的关联。采用分布滞后非线性模型进行时间分层病例交叉分析。美国全国行政医疗索赔数据库。2010年5月至2019年9月期间，所有18岁及以上的商业和医疗保险优势受益人（7420万人）。基于出院诊断代码的任何原因、热相关疾病、肾脏疾病、心血管疾病、呼吸系统疾病和精神障碍的艾德每日访视率。在美国2939个县有健康保险的成年人中记录了21996670次艾德就诊。极端炎热的天数-定义为当地温暖季节的第95个百分位数（五月至九月）温度分布（34.4°C对14.9°C的全国平均水平）-与7.8%的（95%置信区间7.3%至8.2%）任何原因导致艾德访视的超额相对风险，66.3%热相关疾病占60.2%~ 72.7%，肾脏疾病占30.4%（23.4%~ 37.8%），精神障碍占7.9%（5.2%~ 10.7%）。极端高温天数与因高温相关疾病而就诊的艾德绝对风险增加相关，为24.3/100000人（95%置信区间22.9 - 25.7）。高温与心血管或呼吸系统疾病的艾德就诊风险无关。在男性和美国东北部或大陆性气候的县中，这种联系更为明显。在年轻人和老年人中，极端炎热的日子与任何原因的艾德就诊、热相关疾病、肾脏疾病和精神障碍的风险较高相关。这些结果表明，极端高温对健康的不利影响不仅限于老年人，而且对整个年龄范围的成年人的健康具有重要意义。
To quantify the association between ambient heat and visits to the emergency department (ED) for any cause and for cause specific conditions in the conterminous United States among adults with health insurance. Time stratified case crossover analyses with distributed lag non-linear models. US nationwide administrative healthcare claims database. All commercial and Medicare Advantage beneficiaries (74.2 million) aged 18 years and older between May and September 2010 to 2019. Daily rates of ED visits for any cause, heat related illness, renal disease, cardiovascular disease, respiratory disease, and mental disorders based on discharge diagnosis codes. 21 996 670 ED visits were recorded among adults with health insurance living in 2939 US counties. Days of extreme heat—defined as the 95th centile of the local warm season (May through September) temperature distribution (at 34.4°C v 14.9°C national average level)—were associated with a 7.8% (95% confidence interval 7.3% to 8.2%) excess relative risk of ED visits for any cause, 66.3% (60.2% to 72.7%) for heat related illness, 30.4% (23.4% to 37.8%) for renal disease, and 7.9% (5.2% to 10.7%) for mental disorders. Days of extreme heat were associated with an excess absolute risk of ED visits for heat related illness of 24.3 (95% confidence interval 22.9 to 25.7) per 100 000 people at risk per day. Heat was not associated with a higher risk of ED visits for cardiovascular or respiratory diseases. Associations were more pronounced among men and in counties in the north east of the US or with a continental climate. Among both younger and older adults, days of extreme heat are associated with a higher risk of ED visits for any cause, heat related illness, renal disease, and mental disorders. These results suggest that the adverse health effects of extreme heat are not limited to older adults and carry important implications for the health of adults across the age spectrum.
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影响因子：
5.4
作者：
Levy, D;Lumley, T;Checkoway, H
通讯作者：
Checkoway, H
DOI：
10.1016/s0140-6736(14)62114-0
发表时间：
2015-07-25
期刊：
Lancet (London, England)
影响因子：
--
作者：
Gasparrini A;Guo Y;Hashizume M;Lavigne E;Zanobetti A;Schwartz J;Tobias A;Tong S;Rocklöv J;Forsberg B;Leone M;De Sario M;Bell ML;Guo YL;Wu CF;Kan H;Yi SM;de Sousa Zanotti Stagliorio Coelho M;Saldiva PH;Honda Y;Kim H;Armstrong B
通讯作者：
Armstrong B
DOI：
10.3390/ijerph120505256
发表时间：
2015-05-18
影响因子：
--
作者：
Li M;Gu S;Bi P;Yang J;Liu Q
通讯作者：
Liu Q
影响因子：
8.3
作者：
Lippmann, Steven J.;Fuhrmann, Christopher M.;Richardson, David B.
通讯作者：
Richardson, David B.
DOI：
10.1164/rccm.200802-217oc
发表时间：
2009-03-01
影响因子：
24.7
作者：
Michelozzi, Paola;Accetta, Gabriele;Perucci, Carlo A.
通讯作者：
Perucci, Carlo A.