Akdeniz University School of Medicine, Department of Emergency Medicine, Antalya, Turkey.
Ann Acad Med Singap. 2009 Dec;38(12):1081-4.
Previous studies revealed fewer visits for congestive heart failure (CHF) to emergency departments (EDs) in New Jersey, USA and fewer admissions for CHF to a Southern Indian and an Israeli hospital during warmer months. Using hospital admission rate for CHF as a marker for illness severity, we hypothesized that CHF would also be less severe in warmer months.
This is a retrospective cohort study which included all ED visits from 1 January 2004 to 31 January 2006. We analysed the monthly CHF hospital admission rates. We a priori chose to compare the admission rates for the 4 warmest to the 4 coldest months.
Of a total of 136,347 ED visits, 1083 (0.8%) were accounted for CHF. Hospital admission rate was 55.8%. Although there was a statistically significant increase in ED visits for CHF during the colder months, the 4 warmer months from June to September had 1.15 times higher hospital admission rate than the 4 coldest months from November to February.
Contrary to our hypothesis, we found a statistically significant increase in the percentage of CHF visits admitted to the hospital during the warmer months. This suggests that although there are less ED CHF visits in the warmer months, a greater percentage tend to be severe.
先前的研究表明,美国新泽西州因充血性心力衰竭(CHF)前往急诊部(ED)就诊的次数较少,而在温暖的月份,印度南部和以色列的一家医院因 CHF 入院的人数也较少。我们使用 CHF 的入院率作为疾病严重程度的指标,假设在温暖的月份 CHF 的严重程度也会较低。
这是一项回顾性队列研究,纳入了 2004 年 1 月 1 日至 2006 年 1 月 31 日期间所有 ED 就诊。我们分析了每月 CHF 的入院率。我们事先选择比较 4 个最温暖月份和 4 个最寒冷月份的入院率。
在总共 136347 次 ED 就诊中,有 1083 次(0.8%)被诊断为 CHF。入院率为 55.8%。尽管在寒冷月份因 CHF 前往 ED 的就诊次数有统计学上的显著增加,但从 6 月到 9 月的 4 个温暖月份的入院率比从 11 月到 2 月的 4 个最寒冷月份高 1.15 倍。
与我们的假设相反,我们发现温暖月份因 CHF 住院的就诊百分比有统计学上的显著增加。这表明,尽管温暖月份 ED 就诊的 CHF 患者较少,但更严重的患者比例较高。