Department of Emergency Medicine, School of Medicine, University of California, San Diego, CA 92093, USA.
Scripps Institute of Oceanography, University of California, San Diego, CA 92093, USA.
Medicina (Kaunas). 2024 Sep 28;60(10):1593. doi: 10.3390/medicina60101593.
: Extreme heat events are increasing with climate change impacting human health. This study investigates the impact of extreme heat events on Emergency Department (ED) utilization by older adult patients. : We conducted a study of all 324 non-federal hospital EDs in California during an 8-year period from data extracted from the California Department of Health Care Access and Information (HCAI). The study utilized a time-stratified case-crossover design to investigate ED visited in patients aged 65 years and older during 1-day and 2-day heat wave events. Extreme heat temperatures were measured and weighted using historical data at the zip code level at the 95th, 97.5th, and 99th percentiles 2012 through 2019. Conditional logistical regression was used to estimate the odds of ED visits during extreme heat events compared to non-extreme heat days. Stratified analyses by age and comorbidity status were conducted. : During the study period, 8,744,001 of ED visits among older patients were included in the study analysis. Odds ratios (OR) increased for during 1-day heat events (95th percentile (OR = 1.023, 95%CI: 1.020, 1.027), 97.5th percentile (OR = 1.030, 95%CI: 1.025, 1.035), 99th percentile (OR = 1.039, 95%CI: 1.032, 1.058)) and more so with 2-day heat wave events (95th percentile (OR = 1.031, 95%CI: 1.026, 1.036), 97.5th percentile (OR = 1.039, 95%CI: 1.031, 1.046), 99th percentile (OR = 1.044, 95%CI: 1.032, 1.058)). Older patients with three or more comorbidities had the highest odds of ED visits (OR = 1.085, 95%CI: 1.068, 1.112) at the 99th percentile. : Our findings indicate that ED visits increase for older patients during extreme heat events, particularly with event intensity and duration. Older patients with at least one comorbidity were at greater risk.
极端高温事件随着气候变化而增加，影响人类健康。本研究调查了极端高温事件对老年患者急诊就诊的影响。
我们对加利福尼亚州所有 324 家非联邦医院急诊科在 8 年期间的数据进行了研究，这些数据是从加利福尼亚州卫生保健获取和信息部（HCAI）提取的。该研究采用时间分层病例交叉设计，调查了 1 天和 2 天热浪事件中 65 岁及以上患者的急诊就诊情况。使用 2012 年至 2019 年历史 zip 代码级数据测量和加权极端高温温度，位于第 95 百分位、第 97.5 百分位和第 99 百分位。使用条件逻辑回归估计极端高温天气与非极端高温天气相比，急诊就诊的几率。进行了按年龄和合并症状态分层的分析。
在研究期间，将 8744001 例老年患者的急诊科就诊纳入研究分析。1 天的高温事件（第 95 百分位（OR=1.023，95%CI：1.020，1.027），第 97.5 百分位（OR=1.030，95%CI：1.025，1.035），第 99 百分位（OR=1.039，95%CI：1.032，1.058））期间的比值比（OR）增加，2 天热浪事件（第 95 百分位（OR=1.031，95%CI：1.026，1.036），第 97.5 百分位（OR=1.039，95%CI：1.031，1.046），第 99 百分位（OR=1.044，95%CI：1.032，1.058））期间的比值比（OR）增加更为明显。有三种或更多合并症的老年患者在第 99 百分位的急诊就诊几率最高（OR=1.085，95%CI：1.068，1.112）。
我们的研究结果表明，极端高温天气期间老年患者的急诊就诊人数增加，尤其是与事件强度和持续时间有关。至少有一种合并症的老年患者风险更大。
