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美国弗吉尼亚州夏洛茨维尔市热浪对急诊科入院人数的影响

The Impact of Heat Waves on Emergency Department Admissions in Charlottesville, Virginia, U.S.A.

机构信息

Department of Environmental Sciences, University of Virginia, Charlottesville, VA 22904-4123, USA.

Departments of Public Health Sciences and Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA.

出版信息

Int J Environ Res Public Health. 2018 Jul 7;15(7):1436. doi: 10.3390/ijerph15071436.

Abstract

Heat waves have been linked to increases in emergency-related morbidity, but more research is needed on the demographic and disease-specific aspects of these morbidities. Using a case-crossover approach, over 700,000 daily emergency department hospital admissions in Charlottesville, Virginia, U.S.A. from 2005⁻2016 are compared between warm season heat wave and non-heat wave periods. Heat waves are defined based on the exceedance, for at least three consecutive days, of two apparent temperature thresholds (35 °C and 37 °C) that account for 3 and 6% of the period of record. Total admissions and admissions for whites, blacks, males, females, and 20⁻49 years old are significantly elevated during heat waves, as are admissions related to a variety of diagnostic categories, including diabetes, pregnancy complications, and injuries and poisoning. Evidence that heat waves raise emergency department admissions across numerous demographic and disease categories suggests that heat exerts comorbidity influences that extend beyond the more well-studied direct relationships such as heat strokes and cardiac arrest.

摘要

热浪与与急诊相关发病率的增加有关,但仍需要更多的研究来了解这些发病率在人口统计学和疾病特异性方面的情况。本研究使用病例交叉设计,在美国弗吉尼亚州夏洛茨维尔,比较了 2005 年至 2016 年期间 70 多万例每日急诊住院治疗病例,将其分为暖季热浪期和非热浪期。热浪的定义是至少连续三天超过两个体感温度阈值(35°C 和 37°C),这两个阈值分别占记录期的 3%和 6%。热浪期间,总住院人数以及白人、黑人、男性、女性和 20-49 岁人群的住院人数显著增加,与多种诊断类别相关的住院人数也有所增加,包括糖尿病、妊娠并发症以及损伤和中毒。这些证据表明,热浪会导致众多人口统计学和疾病类别下的急诊部门就诊人数增加,这表明热应激对共病的影响超出了研究更为深入的直接关系,如中暑和心搏骤停。

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