Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA.
Am J Epidemiol. 2012 Oct 1;176 Suppl 7:S123-30. doi: 10.1093/aje/kws326.
Although weather changes are known to cause asthma symptoms, their impact on asthma-related health-care utilization is poorly understood. The objective of the present study was to determine the association between short-term outdoor temperature change and asthma-related emergency department (ED) visits among children 3-18 years of age in Detroit, Michigan, in 2000-2001. Descriptive analyses of patient and ED visit characteristics were performed. A case-crossover study utilizing time-stratified controls was conducted to determine the impact of maximum temperature change and change rate measured during 4-, 8-, 12-, and 24-hour periods. Multivariable conditional logistic regression demonstrated the relation between ED visits and temperature change after controlling for other weather and pollutant measures. There were 4,804 asthma-related ED visits during the study period, and they occurred most frequently in the fall and during morning hours. The case-crossover study showed a statistically significant inverse relation between ED visits and maximum 24-hour temperature change after adjustment for climatic factors (for temperature change, odds ratio = 0.992, P = 0.04; for temperature change rate, odds ratio 0.972, P = 0.01). The association persisted after air pollutant measures were added to the model, although the association was not significant. Despite the finding that a greater 24-hour temperature change decreased the risk of asthma-related ED visits, the overall results suggested a negligible association with short-term temperature change.
尽管已知天气变化会引起哮喘症状，但人们对其对与哮喘相关的医疗保健利用的影响知之甚少。本研究的目的是确定密歇根州底特律市 2000-2001 年期间短期室外温度变化与 3-18 岁儿童哮喘相关急诊就诊之间的关系。对患者和急诊就诊特征进行描述性分析。利用时间分层对照进行病例交叉研究，以确定在 4、8、12 和 24 小时期间测量的最大温度变化和变化率的影响。多变量条件逻辑回归显示，在控制其他天气和污染物措施后，急诊就诊与温度变化之间存在关系。在研究期间，有 4804 次哮喘相关的急诊就诊，它们最常发生在秋季和早晨。病例交叉研究表明，在调整气候因素后，急诊就诊与最大 24 小时温度变化之间存在统计学上显著的反比关系（温度变化时，比值比= 0.992，P = 0.04；温度变化率时，比值比 0.972，P = 0.01）。尽管在模型中加入了空气质量污染物措施后，该关联仍然存在，但关联并不显著。尽管发现 24 小时温度变化越大，哮喘相关急诊就诊的风险越低，但总体结果表明与短期温度变化的关联可以忽略不计。
