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环境温度对中国武汉阻塞性肾病住院的影响:一项时间序列分析。

Effects of ambient temperature on hospital admissions for obstructive nephropathy in Wuhan, China: A time-series analysis.

机构信息

Peking University First Hospital, Beijing, China; Institute of Medical Technology, Peking University Health Science Center, Beijing, China.

Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.

出版信息

Ecotoxicol Environ Saf. 2022 Sep 1;242:113876. doi: 10.1016/j.ecoenv.2022.113876. Epub 2022 Jul 13.

Abstract

Under the background of global warming, it has been confirmed that heat exposure has a huge impact on human health. The current study aimed to evaluate the effects of daily mean ambient temperature on hospital admissions for obstructive nephropathy (ON) at the population level. A total of 19,494 hospitalization cases for ON in Wuhan, China from January 1, 2015 to December 31, 2018 were extracted from a nationwide inpatient database in tertiary hospitals according to the International Classification of Diseases (ICD)- 10 codes. Daily ambient meteorological and pollution data during the same period were also collected. A quasi-Poisson Generalized Linear Model (GLM) combined with a distributed lag non-linear model (DLNM) was applied to analyze the lag-exposure-response relationship between daily mean temperature and daily hospital admissions for ON. Results showed that there were significantly positive associations between the daily mean temperature and ON hospital admissions. Relative to the minimum-risk temperature (-3.4 ℃), the risk of hospital admissions for ON at moderate hot temperature (25 ℃, 75th percentile) occurred from lag day 4 and stayed to lag day 12 (cumulative relative risk [RR] was 1.846, 95 % confidence interval [CI]: 1.135-3.005, over lag 0-12 days). Moreover, the risk of extreme hot temperature (32 ℃, 99th percentile) appeared immediately and lasted for 8 days (RR = 2.019, 95 % CI: 1.308-3.118, over lag 0-8 days). Subgroup analyses indicated that the middle-aged and elderly (≥45 years) patients might be more susceptible to the negative effects of high temperature, especially at moderate hot conditions. Our findings suggest that temperature may have a significant impact on the acute progression and onset of ON. Higher temperature is associated with increased risks of hospital admissions for ON, which indicates that early interventions should be taken in geographical settings with relatively high temperatures, particularly for the middle-aged and elderly.

摘要

在全球变暖的背景下,已经证实热暴露对人类健康有巨大影响。本研究旨在评估日平均环境温度对人群中阻塞性肾病(ON)住院的影响。根据国际疾病分类(ICD)第 10 版的编码,从中国一家三级医院的全国住院患者数据库中提取了 2015 年 1 月 1 日至 2018 年 12 月 31 日期间武汉市共 19494 例 ON 住院病例。同时还收集了同期的每日环境气象和污染数据。采用广义线性模型(GLM)结合分布滞后非线性模型(DLNM)分析了日平均温度与 ON 日住院人次的滞后暴露-反应关系。结果表明,日平均温度与 ON 住院人次之间存在显著的正相关关系。与最低风险温度(-3.4℃)相比,中度热(25℃,第 75 百分位数)时 ON 住院的风险从第 4 天开始出现并持续到第 12 天(累积相对风险[RR]为 1.846,95%置信区间[CI]:1.135-3.005,滞后 0-12 天)。此外,极热(32℃,第 99 百分位数)的风险即刻出现并持续 8 天(RR=2.019,95%CI:1.308-3.118,滞后 0-8 天)。亚组分析表明,中年和老年人(≥45 岁)患者可能更容易受到高温的负面影响,尤其是在中度热条件下。我们的研究结果表明,温度可能对 ON 的急性进展和发病有显著影响。较高的温度与 ON 住院风险增加有关,这表明在气温较高的地理区域应采取早期干预措施,特别是针对中年和老年人。

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