Do Vivian, McBrien Heather Kathleen, Edmondson Donald, Kioumourtzoglou Marianthi-Anna, Casey Joan Allison
From the Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY.
Department of Medicine, Columbia Mailman School of Public Health, New York, NY.
Epidemiology. 2025 Jul 1;36(4):458-466. doi: 10.1097/EDE.0000000000001853. Epub 2025 Mar 24.
Power outages are common. They can result in exposure to extreme temperatures by shutting off temperature-controlling devices, and thereby also cause stress. Consequently, outages may precipitate cardiovascular disease (CVD)-related hospitalizations. We assessed this relationship among older adults.
We leveraged 2017-2018 data from 245,452 New York State Medicare Fee-for-Service beneficiaries (65+ years) with 390,530 CVD hospitalizations. Using NY Department of Public Services data, we calculated total hours without power 1 day, 1-2 days, and 1-3 days before case and control periods, with an outage ZIP Code Tabulation Area (ZCTA)-hour defined based on ≥10% of customers in a ZCTA-hour without power in primary analyses. We used a case-crossover study design and ran conditional logistic regression to assess associations separately within each urbanicity level: New York City (NYC), non-NYC urban, and rural areas. We additionally stratified models by warm versus cool season, individual-level age and sex, and ZCTA-level socioeconomic factors. Secondarily, we considered emergency (n = 298,910) and nonemergency hospitalizations separately.
We generally observed null associations between power outages and all CVD hospitalizations across New York State and within subgroups. For example, in NYC, we observed a rate ratio of 1.05 (95% confidence interval: 0.85, 1.30) for each additional power outage hour 1 day prior.
The case-crossover design we used eliminated time-fixed confounding, but there were a limited number of exposed cases, limiting statistical power. Future studies should investigate co-occurring severe weather, span additional years, and evaluate other and broader geographic areas.
停电很常见。停电会导致温度控制设备关闭，使人暴露在极端温度下，从而造成压力。因此，停电可能会促使与心血管疾病（CVD）相关的住院治疗。我们评估了老年人中的这种关系。
我们利用了2017 - 2018年来自纽约州245,452名医疗保险按服务付费受益人群（65岁及以上）的数据，这些人群中有390,530次心血管疾病住院治疗记录。利用纽约公共服务部的数据，我们计算了病例期和对照期前1天、1 - 2天以及1 - 3天无电总时长，在主要分析中，停电邮政编码分区小时（ZCTA - hour）的定义是基于某个ZCTA - hour内≥10%的客户无电。我们采用病例交叉研究设计，并进行条件逻辑回归分析，以分别评估每个城市化水平（纽约市、非纽约市城市和农村地区）内的关联。我们还按暖季与冷季、个体层面的年龄和性别以及ZCTA层面的社会经济因素对模型进行分层。其次，我们分别考虑了急诊（n = 298,910）和非急诊住院情况。
我们在纽约州及各亚组中，总体上观察到停电与所有心血管疾病住院之间无关联。例如，在纽约市，我们观察到病例期前1天每增加1小时停电，发病率比值为1.05（95%置信区间：0.85，1.30）。
我们采用的病例交叉设计消除了时间固定的混杂因素，但暴露病例数量有限，限制了统计效力。未来的研究应调查同时发生的恶劣天气情况，涵盖更多年份，并评估其他更广泛的地理区域。
