Smith Wally R, Coyne Patrick, Smith Virginia S, Mercier Bruce
Division of Quality Health Care, Virginia Commonwealth University, 1200 E. Broad St, Rm 10-402, , Richmond, VA 23298-0306, USA.
Pain Manag Nurs. 2003 Sep;4(3):106-11. doi: 10.1016/s1524-9042(02)54211-9.
Weather changes are among the proposed precursors of painful sickle cell crises. However, epidemiologic data are mixed regarding the relationship between ambient temperature and crisis frequency. To study this relationship among a local sickle cell disease population, emergency department (ED) visits and admissions were evaluated in adults with sickle cell crisis as the primary diagnosis at a major teaching hospital in a temperate climate. Official daily ambient temperatures (average for that day) were obtained from the National Climate Data Center for the days patients visited the ED or were hospitalized, and for 24 or 48 hours prior. Daily ED visit counts and admission counts were correlated with the visit/admission day's ambient temperature, with the ambient temperature 24 hours before admission, and with the magnitude of change in daily ambient temperature over the prior 24 or 48 hours. For all correlations, statistical significance was defined as a p value of <0.01 and clinical significance was defined as a moderate or greater correlation, absolute value of r >/= 0.30. ED visits or admissions correlated statistically, but not clinically, with daily temperatures. On days when temperatures were <32 degrees F or >80 degrees F, these correlations were statistically significant, but clinical significance was variable. ED visits or admissions correlated only statistically with temperatures 24 hours prior, even on days when temperatures were <32 degrees F. When temperatures were >80 degrees F, the correlations were statistically significant, but there was a reverse, clinically significant correlation between admissions and temperatures. Finally, only statistically significant correlations were found between ED visits or admissions and change in temperature over the prior 24 or 48 hours. Weak or inconsistent confirmation of a relationship was found between daily ambient temperatures and ED visits or hospital admissions for sickle cell crises.
天气变化被认为是镰状细胞危象疼痛发作的先兆之一。然而，关于环境温度与危象发生频率之间的关系，流行病学数据并不一致。为了研究当地镰状细胞病患者群体中的这种关系，我们在一个气候温和地区的一家大型教学医院，对以镰状细胞危象为主要诊断的成年患者的急诊科（ED）就诊和住院情况进行了评估。从国家气候数据中心获取患者就诊或住院当天以及之前24或48小时的官方每日环境温度（当日平均值）。每日ED就诊次数和住院次数与就诊/住院当天的环境温度、入院前24小时的环境温度以及前24或48小时内每日环境温度的变化幅度进行了相关性分析。对于所有相关性分析，统计学显著性定义为p值<0.01，临床显著性定义为中度或更强的相关性，r的绝对值≥0.30。ED就诊或住院次数与每日温度在统计学上相关，但在临床上不相关。当温度低于32华氏度或高于80华氏度时，这些相关性在统计学上具有显著性，但临床显著性存在差异。ED就诊或住院次数仅与入院前24小时的温度在统计学上相关，即使在温度低于32华氏度的日子也是如此。当温度高于80华氏度时，相关性在统计学上具有显著性，但住院次数与温度之间存在反向的临床显著性相关性。最后，仅在ED就诊或住院次数与前24或48小时内温度变化之间发现了统计学显著性相关性。对于镰状细胞危象，每日环境温度与ED就诊或住院之间的关系得到的证实较弱或不一致。
