Centre d'Investigation Clinique Antilles Guyane, CIC INSERM 1424, Andrée Rosemon General Hospital, Cayenne 97300, French Guiana.
Sickle Cell Disease Center, Andrée Rosemon General Hospital, Cayenne 97300, French Guiana.
Int J Environ Res Public Health. 2019 Jul 31;16(15):2724. doi: 10.3390/ijerph16152724.
(1) Objectives: French Guiana is the French territory most affected by sickle cell disease (SCD). This study investigates the associations between different environmental factors relative to climate, infectious outbreaks, and emergency visits or weekly hospital admissions for vaso-occlusive crisis (VOC). The identification of risk factors would lead to better patient care and patient management, and more targeted prevention and therapeutic education for patients with SCD in French Guiana. (2) Methods: This study was performed using data collected from the medicalized information system and emergency medical records of Cayenne General Hospital, between 1 January 2010 and 31 December 2016. ARIMA models were used to investigate the potential impact of weather conditions and flu epidemics on VOC occurrence. (3) Results: During the study period, 1739 emergency visits were recorded among 384 patients, of which 856 (49.2%) resulted in hospitalization, 811 (46.6%) resulted in hospital discharge, and 72 (4.2%) in another orientation. Decreased temperature and decreased humidity were both independent factors associated with an increase of VOC cases ( = 0.0128 and = 0.0004, respectively). When studying severe VOC (leading to hospitalization, with or without prior emergency visit), 2104 hospital admissions were recorded for 326 patients. The only factor associated with severe VOC, in the multivariate analysis, was flu epidemics ( = 0.0148). (4) Conclusions: This study shows a link between climate, flu epidemics, and VOC in French Guiana. Patient's awareness of risks related to climate and flu epidemics should be encouraged, as home prevention measures can help avoid painful crises. Moreover, physicians should encourage patients to get immunized for influenza every year.
（1）目的：法属圭亚那是受镰状细胞病（SCD）影响最严重的法国领土。本研究调查了与气候、传染病爆发以及血管阻塞性危象（VOC）急诊或每周住院相关的不同环境因素之间的关联。确定危险因素将有助于更好地为圭亚那的 SCD 患者提供护理和管理，并为患者提供更有针对性的预防和治疗教育。（2）方法：本研究使用了 2010 年 1 月 1 日至 2016 年 12 月 31 日期间从卡宴综合医院医疗信息系统和急诊病历中收集的数据。使用 ARIMA 模型来研究天气条件和流感流行对 VOC 发生的潜在影响。（3）结果：在研究期间，在 384 名患者中记录了 1739 次急诊，其中 856 次（49.2%）导致住院，811 次（46.6%）导致出院，72 次（4.2%）导致另一种治疗方向。温度降低和湿度降低都是与 VOC 病例增加相关的独立因素（分别为 = 0.0128 和 = 0.0004）。在研究严重的 VOC（导致住院，无论是否有急诊）时，记录了 326 名患者的 2104 次住院。在多变量分析中，唯一与严重 VOC 相关的因素是流感流行（ = 0.0148）。（4）结论：本研究表明，法属圭亚那的气候、流感流行与 VOC 之间存在关联。应鼓励患者了解与气候和流感流行相关的风险，因为家庭预防措施有助于避免疼痛危机。此外，医生应鼓励患者每年接种流感疫苗。
