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Ferraro SL, Chiu AK, Seibold BT, Gu A, Agarwal AR, Dance S, Thakkar SC, Tabaie S. A National Database Analysis: Does Cold Weather Affect the Surgical Intervention Rate for Developmental Dysplasia of the Hip in Children Under Five Years? Cureus 2024; 16:e57998. [PMID: 38606022 PMCID: PMC11006625 DOI: 10.7759/cureus.57998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 04/13/2024] Open
Abstract
Background Cold weather in the first few months of life may increase the risk of a late diagnosis of developmental dysplasia of the hip (DDH). Early detection of DDH can often be treated non-surgically. The purpose of this study is to observe whether the rates of surgical intervention for DDH differ based on average outdoor temperatures in the winter months. Methods A retrospective observational study of DDH patients diagnosed from 2010 to 2021 was conducted using a national administrative database. Five geographic regions were defined based on the average temperatures in the coldest quarter of the year. The rates of DDH-related surgeries were compared across these temperature regions. Results A total of 55,911 patients ≤5 years old with a DDH diagnosis from 2010 to 2021 were identified in the database. When compared to the warmest region (Group 5), the coldest region (Group 1) had higher rates of open reduction (4.59% vs. 2.06%, p<0.001), adductor tenotomy (6.95% vs. 2.91%, p<0.001), femoral osteotomy (5.75% vs. 2.04%, p<0.001), pelvic osteotomy (5.27% vs. 2.04%, p<0.001), and total DDH surgeries (11.42% vs. 5.03%, p<0.001). Conclusion Children living in states with an average winter temperature of -6.17°C had an increased likelihood of requiring surgical intervention for DDH within the first five years of life.
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Affiliation(s)
- Samantha L Ferraro
- Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Anthony K Chiu
- Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - B Tanner Seibold
- Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Alex Gu
- Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Amil R Agarwal
- Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Sarah Dance
- Orthopaedic Surgery, Children's National Hospital, Washington DC, USA
| | | | - Sean Tabaie
- Orthopaedic Surgery, Children's National Hospital, Washington DC, USA
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Wu WJ, Hutton J, Zordan R, Ranse J, Crilly J, Tutticci N, English T, Currie J. Review article: Scoping review of the characteristics and outcomes of adults presenting to the emergency department during heatwaves. Emerg Med Australas 2023; 35:903-920. [PMID: 37788821 DOI: 10.1111/1742-6723.14317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 10/05/2023]
Abstract
As a result of climate change heatwaves are expected to increase in frequency and intensity and will have detrimental impacts on human health globally. EDs are often the critical point of care for acute heat illnesses and other conditions associated with heat exposure. Existing literature has focused on heatwave-related hospitalisation and mortality. This scoping review aimed to identify, evaluate and summarise current literature regarding patient characteristics and outcomes of ED admissions from heatwaves. A scoping review of the literature was conducted using six databases: Medline, EMBASE, EMCARE, CINAHL, PsycINFO, and Scopus, using MeSH terms and keywords related to 'heatwave' and 'Emergency Department'. Articles were included if they were: published in English from January 2000 to August 2021, related to ED, and examined high temperature periods consistent with heatwave criteria. Articles were appraised using the Mixed Methods Appraisal Tool (MMAT). Thirty-one studies were included, mostly from the United States, Australia, and France. The study designs include retrospective case analysis, case-control, and time-series analysis. Eight studies examined known heatwaves, 21 used different criteria to identify heatwave occurrence, and two focused on heat-related illness. The selected articles display a moderate-high quality on MMAT. ED admissions for both heat-related illnesses and other conditions increased during heatwaves, with up to 18.5 times risk increase. The risk was elevated for all population groups, and substantially in the elderly, male patients with certain comorbidities, medications, or lower socioeconomic status. Outcomes including hospitalisation and mortality rates after ED admissions showed positive associations with heatwaves. The heatwaves resulting from climate change will place increasing demands on EDs providing care for increasingly susceptible populations. Significant public heatwave planning across multiple sectors is required to reduce the risk of overwhelming EDs with these patients.
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Affiliation(s)
- Wendy Jingyi Wu
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennie Hutton
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Rachel Zordan
- Education and Learning, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Julia Crilly
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - Naomi Tutticci
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Timothy English
- Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Currie
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Wolf ST, Vecellio DJ, Kenney WL. Adverse heat-health outcomes and critical environmental limits (Pennsylvania State University Human Environmental Age Thresholds project). Am J Hum Biol 2023; 35:e23801. [PMID: 36125292 PMCID: PMC9840654 DOI: 10.1002/ajhb.23801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/24/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The earth's climate is warming and the frequency, duration, and severity of heat waves are increasing. Meanwhile, the world's population is rapidly aging. Epidemiological data demonstrate exponentially greater increases in morbidity and mortality during heat waves in adults ≥65 years. Laboratory data substantiate the mechanistic underpinnings of age-associated differences in thermoregulatory function. However, the specific combinations of environmental conditions (i.e., ambient temperature and absolute/relative humidity) above which older adults are at increased risk of heat-related morbidity and mortality are less clear. METHODS This review was conducted to (1) examine the recent (past 3 years) literature regarding heat-related morbidity and mortality in the elderly and discuss projections of future heat-related morbidity and mortality based on climate model data, and (2) detail the background and unique methodology of our ongoing laboratory-based projects aimed toward identifying the specific environmental conditions that result in elevated risk of heat illness in older adults, and the implications of using the data toward the development of evidence-based safety interventions in a continually-warming climate (PSU HEAT; Human Environmental Age Thresholds). RESULTS The recent literature demonstrates that extreme heat continues to be increasingly detrimental to the health of the elderly and that this is apparent across the world, although the specific environmental conditions above which older adults are at increased risk of heat-related morbidity and mortality remain unclear. CONCLUSION Characterizing the environmental conditions above which risk of heat-related illnesses increase remains critical to enact policy decisions and mitigation efforts to protect vulnerable people during extreme heat events.
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Affiliation(s)
- S. Tony Wolf
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802
| | - Daniel J. Vecellio
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802
| | - W. Larry Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802
- Graduate Program in Physiology, The Pennsylvania State University, University Park, PA, 16802
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Davis RE, Driskill EK, Novicoff WM. The Association between Weather and Emergency Department Visitation for Diabetes in Roanoke, Virginia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1589-1597. [PMID: 35583606 DOI: 10.1007/s00484-022-02303-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/12/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
Diabetes mellitus imposes a significant and increasing health burden on the US population. Our objective is to determine if weather is related to daily variations in emergency department (ED) visits for diabetes mellitus in Roanoke, Virginia. A time series of daily ED visits for diabetes mellitus at the Carilion Clinic in southwestern Virginia is associated with daily minimum temperature from 2010-2017. Associations between ED visits (through a 14-day lag period) and temperature are examined using generalized additive models and distributed lag nonlinear models. Heat and cold waves are identified at low and high thresholds, and ED visitation during these events is compared to prior control periods using a time-stratified case crossover approach. ED visits for diabetes exhibit a U-shaped relationship with temperature, with a higher relative risk (RR) during cold events (RR = 1.05) vs. warm events (RR = 1.02). When minimum temperatures are below freezing, ED visitation peaks starting 2 days afterward, with RRs approaching 1.04. The RR on warm days (minimum temperature > 10 °C) approaches 1.02 but peaks on the day of or the day following the elevated temperatures. Cold waves increase the odds of ED visits by up to 11% (p = 0.01), whereas heat waves exhibit no significant effect (p = 0.07). The increasing health burden linked to diabetes requires new research on environmental factors that might exacerbate related illness. When examined in the context of climate change impacts on local weather variations, these kinds of linkages between environment and disease can aid in facility staffing and public health messaging during extreme weather events.
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Affiliation(s)
- Robert E Davis
- Department of Environmental Sciences, University of Virginia, P.O. Box 400123, Charlottesville, VA, 22904-4123, USA.
| | - Elizabeth K Driskill
- School of Medicine, University of Virginia, P.O. Box 800159HSC, Charlottesville, VA, 22908, USA
| | - Wendy M Novicoff
- Departments of Public Health and Orthopaedic Surgery, School of Medicine, University of Virginia, P.O. Box 800159HSC, Charlottesville, VA, 22908, USA
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Berberian AG, Gonzalez DJX, Cushing LJ. Racial Disparities in Climate Change-Related Health Effects in the United States. Curr Environ Health Rep 2022; 9:451-464. [PMID: 35633370 PMCID: PMC9363288 DOI: 10.1007/s40572-022-00360-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Climate change is causing warming over most parts of the USA and more extreme weather events. The health impacts of these changes are not experienced equally. We synthesize the recent evidence that climatic changes linked to global warming are having a disparate impact on the health of people of color, including children. RECENT FINDINGS Multiple studies of heat, extreme cold, hurricanes, flooding, and wildfires find evidence that people of color, including Black, Latinx, Native American, Pacific Islander, and Asian communities are at higher risk of climate-related health impacts than Whites, although this is not always the case. Studies of adults have found evidence of racial disparities related to climatic changes with respect to mortality, respiratory and cardiovascular disease, mental health, and heat-related illness. Children are particularly vulnerable to the health impacts of climate change, and infants and children of color have experienced adverse perinatal outcomes, occupational heat stress, and increases in emergency department visits associated with extreme weather. The evidence strongly suggests climate change is an environmental injustice that is likely to exacerbate existing racial disparities across a broad range of health outcomes.
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Affiliation(s)
- Alique G Berberian
- Department of Environmental Health Sciences, University of California, 650 Charles E. Young Drive South, 71-259 CHS, Los Angeles, CA, 90095, USA
| | - David J X Gonzalez
- School of Public Health and Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA, USA
| | - Lara J Cushing
- Department of Environmental Health Sciences, University of California, 650 Charles E. Young Drive South, 71-259 CHS, Los Angeles, CA, 90095, USA.
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Forecasting and explaining emergency department visits in a public hospital. J Intell Inf Syst 2022. [DOI: 10.1007/s10844-022-00716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Giamello JD, Melchio R, Bertolaccini L, Caraccio P, Rendina C, Lauria G. Climatic factors influence on emergency department visits. HONG KONG J EMERG ME 2022. [DOI: 10.1177/10249079221092897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jacopo Davide Giamello
- School of Emergency Medicine, University of Turin, Turin, Italy
- Department of Emergency Medicine, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Remo Melchio
- Department of Internal Medicine, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Luca Bertolaccini
- Department of Thoracic Surgery, IEO Istituto Europeo di Oncologia, Milan, Italy
| | | | | | - Giuseppe Lauria
- Department of Emergency Medicine, Santa Croce e Carle Hospital, Cuneo, Italy
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Zhai G, Qi J, Zhang X, Zhou W, Wang J. A comparison of the effect of diurnal temperature range and apparent temperature on cardiovascular disease among farmers in Qingyang, Northwest China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:28946-28956. [PMID: 34988800 DOI: 10.1007/s11356-021-17785-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/23/2021] [Indexed: 06/14/2023]
Abstract
Climate change is increasing the incidence of extreme weather events which have a significant impact on public health. Cardiovascular diseases (CVDs) are the number one cause of death globally (40%). Apparent temperature (AT) and diurnal temperature range (DTR) have been extensively used to evaluate the effects of temperature on cardiovascular disease (CVD). However, the relevant information is quite limited from analysis and comparison of effects and differing pathogenesis of DTR and AT on CVD especially in less-developed, rural areas of China. This is the first attempt to analyze different effects between AT and DTR on CVD using distributed lag nonlinear modeling (DLNM) in rural area. Data on CVD hospital admission in Qingyang (Northwest China) in 2014-2017 originated from the New Rural Cooperative Medical System (NRCMS) of Gansu Province, and meteorological variables were provided by the Meteorological Science Data Sharing Service. Both AT and DTR had significant nonlinear and delayed impacts on hospital admissions for CVD. DTR had a stronger and more persistent effect on CVD incidence than AT. Females were more affected by high AT and low DTR than were males, while males were more vulnerable to low AT and high DTR. Temperature effects were not significantly different between people above and below 65 years of age. These findings provide local public health authorities with reference concerning sensitive temperature indices for susceptible populations with a view to improve CVD preventive strategies in rural areas.
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Affiliation(s)
- Guangyu Zhai
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, China
- School of Management, Lanzhou University, Lanzhou, 730000, China
| | - Jintao Qi
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, China.
| | - Xuemei Zhang
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Wenjuan Zhou
- Gansu Provincial Hospital, Lanzhou, 730000, China
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Yang Z, Song K, Lin H, Li C, Ding N. Factors Associated with Emergency Department Length of Stay in Critically Ill Patients: A Single-Center Retrospective Study. Med Sci Monit 2021; 27:e931286. [PMID: 34333509 PMCID: PMC8336256 DOI: 10.12659/msm.931286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Length of stay (LOS) in the emergency department (ED) should be measured and evaluated comprehensively as an important indicator of hospital emergency service. In this study, we aimed to analyze clinical characteristics of critically ill patients admitted to the ED and identify the factors associated with LOS. MATERIAL AND METHODS All patients with level 1 and level 2 of the Emergency Severity Index who were admitted to the ED from January 2018 to December 2019 were included in this retrospective study. The patients were divided into 2 groups: LOS ≥4 h and LOS <4 h. Variables were comprehensively analyzed and compared between the 2 groups. RESULTS A total of 19 616 patients, including 7269 patients in the LOS ≥4 h group and 12 347 patients in the LOS <4 group, were included. Advanced age, admission in winter and during the night shift, and diseases excluding nervous system diseases, cardiovascular diseases, and trauma were associated with higher risk of LOS. Nervous system diseases, cardiovascular diseases, trauma, and procedures including tracheal intubation, surgery, percutaneous coronary intervention, and thrombolysis were associated with lower risk of LOS. CONCLUSIONS Prolonged LOS in the ED was associated with increased age and admission in winter and during the night shift, while shortened LOS was associated with nervous system diseases, cardiovascular diseases, and trauma, as well as with procedures including tracheal intubation, surgery, percutaneous coronary intervention, and thrombolysis. Our findings can serve as a guide for ED physicians to individually evaluate patient condition and allocate medical resources more effectively.
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Affiliation(s)
- Zhiwei Yang
- Department of Emergency Medicine, Changsha Central Hospital, University of South China, Changsha, Hunan, China (mainland)
| | - Kun Song
- Department of Emergency Medicine, Changsha Central Hospital, University of South China, Changsha, Hunan, China (mainland)
| | - Hang Lin
- Department of Emergency Medicine, Changsha Central Hospital, University of South China, Changsha, Hunan, China (mainland)
| | - Changluo Li
- Department of Emergency Medicine, Changsha Central Hospital, University of South China, Changsha, Hunan, China (mainland)
| | - Ning Ding
- Department of Emergency Medicine, Changsha Central Hospital, University of South China, Changsha, Hunan, China (mainland)
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Pakdemirli A, Bayram B, Güvenç E, Ellidokuz H. Evaluation of ambulance calls for patients over 65 years of age in İzmir, Turkey: a two- year retrospective analysis. Turk J Med Sci 2021; 51:1253-1260. [PMID: 33726483 PMCID: PMC8283469 DOI: 10.3906/sag-2010-152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/14/2021] [Indexed: 11/26/2022] Open
Abstract
Background/aim Analysis of interventions for special patient groups is important for the planning of health services, especially emergency medical services. In this study, we aimed to evaluate emergency medical service (EMS) interventions for the elderly and determine the decisive factors affecting transfer to the hospital of EMS team over 2 years (2017 and 2018) in İzmir. Materials and methods Records of 112 emergency calls that were made between 2017 and 2018 followed up with interventions for patients aged 65 years and older were obtained from the 112 system. The reasons for the calls, outcomes, possible diagnoses of the patients, differences in time intervals and seasons, characteristics of the patients transferred to the hospital, and factors affecting the need for transfer to the hospital were investigated. Results A total of 176,104 elderly patients with a mean age of 78.02 ± 8.0 years required ambulance services, and out of them, 66% were transferred to the hospital. Transfer to the hospital was significantly associated with the event location, sex, time interval, international classification of diseases (ICD) codes, and physical examination findings. Conclusion Ambulance interventions are more frequently required in urban areas than in the countryside, and calls are mostly made during daytime hours and during winter months. The decision to transfer a patient to the hospital is based on the patient’s respiratory status, skin examination, state of consciousness, pulse, systolic blood pressure, call time, and the preliminary diagnosis of the crew.
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Affiliation(s)
- Ahu Pakdemirli
- Department of Physiology, Gülhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Başak Bayram
- Department of Emergency Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Erkan Güvenç
- Department of Emergency Medicine, Buca Seyfi Demirsoy State Hospital, İzmir, Turkey
| | - Hülya Ellidokuz
- Department of Preventative Oncology, Dokuz Eylül University, İzmir, Turkey
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