Heat, heat waves, and hospital admissions among the elderly in the United States, 1992-2006.
Heat, heat waves, and hospital admissions among the elderly in the United States, 1992-2006.
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DOI：
10.1289/ehp.1206132
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发表时间：
2014-11
影响因子：
10.4
通讯作者：
O'Neill MS
中科院分区：
文献类型：
--
作者：
Gronlund CJ;Zanobetti A;Schwartz JD;Wellenius GA;O'Neill MS
背景：随着全球气候变化，热浪的频率、强度和持续时间都在增加。高温与老年人死亡率之间的关系已有很好的文献记载，但与住院率之间的关系却知之甚少。目的：我们的目标是确定美国五个气候区114个城市中≥ 65岁的医疗保险受益人中中度和极端高温，热浪和非意外原因住院之间的关联。研究方法：我们使用1992年至2006年的医疗保险住院患者账单记录和城市特定的温度、湿度和臭氧数据，采用时间分层病例交叉设计，估计住院与中度（表观温度（AT）的第90百分位数）和极端（AT的第99百分位数）高温和热浪（AT在2-8天内高于第95百分位数）之间的相关性。在敏感性分析中，我们还考虑了臭氧和假期，不同的温度指标，以及替代模型的可靠性-响应关系的混淆。结果如下：中度高温和住院之间的关联很小，但极端高温与随后8天内全因住院增加3%（95%CI：2%，4%）相关。在原因特异性分析中，极端高温与肾脏（15%; 95% CI：9%，21%）和呼吸系统（4%; 95% CI：2%，7%）疾病的住院率增加相关，但与心血管疾病无关。观察到肾脏和呼吸道入院的额外热浪效应。结论：在美国的老年人中，极端高温与住院率的增加有关，特别是肾脏原因。引文：Gronlund CJ，Zanobetti A，Schwartz JD，Wellenius GA，奥尼尔MS. 2014。1992-2006年美国老年人的高温、热浪和住院率。环境健康展望122：1187-1192; http：dx.doi.org/10.1289/ehp.1206132
Background: Heat-wave frequency, intensity, and duration are increasing with global climate change. The association between heat and mortality in the elderly is well documented, but less is known regarding associations with hospital admissions. Objectives: Our goal was to determine associations between moderate and extreme heat, heat waves, and hospital admissions for nonaccidental causes among Medicare beneficiaries ≥ 65 years of age in 114 cities across five U.S. climate zones. Methods: We used Medicare inpatient billing records and city-specific data on temperature, humidity, and ozone from 1992 through 2006 in a time-stratified case-crossover design to estimate the association between hospitalization and moderate [90th percentile of apparent temperature (AT)] and extreme (99th percentile of AT) heat and heat waves (AT above the 95th percentile over 2–8 days). In sensitivity analyses, we additionally considered confounding by ozone and holidays, different temperature metrics, and alternate models of the exposure–response relationship. Results: Associations between moderate heat and hospital admissions were minimal, but extreme heat was associated with a 3% (95% CI: 2%, 4%) increase in all-cause hospital admissions over the subsequent 8 days. In cause-specific analyses, extreme heat was associated with increased hospitalizations for renal (15%; 95% CI: 9%, 21%) and respiratory (4%; 95% CI: 2%, 7%) diseases, but not for cardiovascular diseases. An added heat-wave effect was observed for renal and respiratory admissions. Conclusion: Extreme heat is associated with increased hospital admissions, particularly for renal causes, among the elderly in the United States. Citation: Gronlund CJ, Zanobetti A, Schwartz JD, Wellenius GA, O’Neill MS. 2014. Heat, heat waves, and hospital admissions among the elderly in the United States, 1992–2006. Environ Health Perspect 122:1187–1192; http://dx.doi.org/10.1289/ehp.1206132
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影响因子：
2
作者：
Gasparrini, A.;Armstrong, B.;Kenward, M. G.
通讯作者：
Kenward, M. G.
影响因子：
8.3
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影响因子：
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DOI：
10.1016/0197-2456(86)90046-2
发表时间：
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期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
DOI：
10.1164/rccm.201211-1969oc
发表时间：
2013-05-15
影响因子：
24.7
作者：
Anderson, G. Brooke;Dominici, Francesca;Peng, Roger D.
通讯作者：
Peng, Roger D.