Gestal Romaní Santiago, Figueiras Adolfo, Royé Dominic
Hospital Clínico Universitario de Santiago de Compostela, Servicio de Cardiología. Rua Choupana s/n, 15706 Santiago de Compostela, A Coruña, Spain.
Spanish Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain.
Environ Health (Wash). 2023 Jun 26;1(1):6-14. doi: 10.1021/envhealth.3c00003. eCollection 2023 Jul 21.
Climate change has increased interest in the effects of the thermal environment on cardiovascular health. Most studies have focused on mortality data. However, pre-hospital care data are better able to evaluate these effects, as they can register the full spectrum of the disease in real time. This scoping review aims to synthesize the epidemiological evidence regarding the effects of the thermal environment on cardiovascular morbidity in the pre-hospital setting, evaluated through ambulance calls. A staged literature search was performed using the PubMed database for the period between 1st January 2000 and 30th March 2023, using the MeSH terms "Weather" AND "Emergency Medical Services". A total of 987 publications were identified that examined the correlation between the thermal environment and ambulance call-outs for cardiovascular causes. The studies were mostly ecological time series, with significant variability in the methodological aspects employed. An increase in the number of ambulance call-outs has been observed in association with low temperatures, both for overall cardiovascular pathologies and for certain pathological subtypes. For high temperatures, no effect has been observed in overall call-outs, although an increase has been observed during heat waves. The demand for ambulances for cardiac arrests is increased by both low and high temperatures and during heat waves. Ambulance call-outs for cardiovascular causes increase with low temperatures and heat waves, with no significant increase in the overall demand associated with high temperatures. Ambulance call-outs for cardiac arrests are the only subtype that is increased by high temperatures.
气候变化使人们对热环境对心血管健康的影响愈发关注。大多数研究都聚焦于死亡率数据。然而，院前护理数据能更好地评估这些影响，因为它们可以实时记录疾病的全貌。本综述旨在综合关于热环境对院前环境中心血管疾病发病率影响的流行病学证据，通过救护车呼叫情况进行评估。使用PubMed数据库，以“天气”和“紧急医疗服务”作为医学主题词，对2000年1月1日至2023年3月31日期间进行了分阶段文献检索。共识别出987篇研究热环境与心血管病因救护车出诊之间相关性的出版物。这些研究大多是生态时间序列研究，在采用的方法学方面存在显著差异。已观察到，无论是总体心血管疾病还是某些病理亚型，救护车出诊次数的增加都与低温有关。对于高温，总体出诊情况未观察到影响，不过在热浪期间出诊次数有所增加。低温、高温以及热浪期间，心脏骤停的救护车需求均会增加。心血管病因的救护车出诊次数随低温和热浪增加，而与高温相关的总体需求无显著增加。心脏骤停的救护车出诊是唯一因高温而增加的亚型。
