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热相关疾病:2002-2008 年乔治亚州急诊科就诊患者住院的预测因素。

Heat illness: predictors of hospital admissions among emergency department visits-Georgia, 2002-2008.

机构信息

Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, MS C-18, Atlanta, GA, 30329, USA,

出版信息

J Community Health. 2014 Feb;39(1):90-8. doi: 10.1007/s10900-013-9743-4.

DOI:10.1007/s10900-013-9743-4
PMID:23934476
Abstract

Heat-related illnesses (HRI) are the most frequent cause of environmental exposure-related injury treated in US emergency departments (ED). While most individuals with HRI evaluated in EDs are discharged to home, understanding predictors of individuals hospitalized with HRI may help public health practitioners and medical providers identify high risk groups who would benefit from educational outreach. We analyzed data collected by the Georgia Department of Public Health, Office of Health Indicators for Planning, regarding ED and hospital discharges for HRI, as identified by ICD-9 codes, between 2002 and 2008 to determine characteristics of individuals receiving care in EDs. Temperature data from CDC's Environmental Public Health Tracking Network were linked to the dataset to determine if ED visits occurred during an extreme heat event (EHE). A multivariable logistic regression model was developed to determine characteristics predicting hospitalization versus ED discharge using demographic characteristics, comorbid conditions, socioeconomic status, the public health district of residence, and the presence of an EHE. Men represented the majority of ED visits (75 %) and hospitalizations (78 %). In the multivariable model, the odds of admission versus ED discharge with an associated HRI increased with age among both men and women, and odds were higher among residents of specific public health districts, particularly in the southern part of the state. Educational efforts targeting the specific risk groups identified by this study may help reduce the burden of hospitalization due to HRI in the state of Georgia.

摘要

热相关疾病(HRI)是美国急诊部门(ED)治疗的与环境暴露相关的最常见损伤原因。虽然大多数在 ED 中评估的 HRI 患者都被送回家,但了解因 HRI 住院的个体的预测因素可能有助于公共卫生从业者和医疗提供者识别出受益于教育外展的高风险群体。我们分析了佐治亚州公共卫生部健康指标规划办公室收集的数据,这些数据涉及 2002 年至 2008 年期间因 ICD-9 代码确定的 HRI 的 ED 和医院出院情况,以确定在 ED 接受治疗的个体的特征。疾病预防控制中心环境公共卫生追踪网络的温度数据与数据集相关联,以确定 ED 就诊是否发生在极端高温事件(EHE)期间。使用人口统计学特征、合并症、社会经济状况、居住的公共卫生区以及是否存在 EHE,开发了多变量逻辑回归模型来确定预测住院与 ED 出院的特征。男性占 ED 就诊(75%)和住院(78%)的大多数。在多变量模型中,男性和女性的年龄越大,与 HRI 相关的入院与 ED 出院的几率就越高,特定公共卫生区的居民(特别是州南部)的几率更高。针对本研究确定的特定风险群体的教育工作可能有助于减轻佐治亚州因 HRI 住院的负担。

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