1
|
Yoshizawa H, Hattori S, Yoshida KI, Maeda H, Kitamura T, Morii E. Association of atmospheric temperature with out-of-hospital natural deaths occurrence before and during the COVID-19 pandemic in Osaka, Japan. Sci Rep 2023; 13:18529. [PMID: 37898701 PMCID: PMC10613267 DOI: 10.1038/s41598-023-45816-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/24/2023] [Indexed: 10/30/2023] Open
Abstract
In this study, we aimed to investigate the relationship between out-of-hospital natural death (OHND) and ambient temperature and examine the seriousness of the impact of the coronavirus disease-2019 (COVID-19) pandemic on this relationship. We used data from the Osaka Prefectural Office of Medical Examiners between 2018 and 2022 and performed a retrospective observational study. A Poisson regression model was applied to examine the relationship between OHND and temperature in Osaka City. The relative risk of OHND at 5 °C and 32 °C compared to the minimum mortality temperature increased from 1.81 in the pre-COVID-19 period to 2.03 in the post-COVID-19 period at 5 °C and from 1.29 in the pre-COVID-19 period to 1.60 in the post-COVID-19 period at 32 °C. The increase in relative risk per 1 °C increase from the pre- to post-COVID-19 period was 1.0551 (rate ratio [RR], p = 0.003) in the hot environment and 1.0233 (RR, p = 0.013) in the cold environment, which was larger than that in the hot environment. Although the risk of OHND increased at both temperatures, the change in OHND risk during post-COVID-19 was larger in the hot environment than in the cold environment, implicating the effect of pandemics in the current scenario of global warming.
Collapse
Affiliation(s)
- Hidenori Yoshizawa
- Department of Diagnostic Pathology, Osaka University Hospital, Suita City, Osaka, Japan.
- Osaka Prefectural Office of Medical Examiner, 1-6 Bamba-cho, Chuo-ku, Osaka City, 540-0007, Osaka, Japan.
| | - Satoshi Hattori
- Department of Biomedical Statistics, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
| | - Ken-Ichi Yoshida
- Osaka Prefectural Office of Medical Examiner, 1-6 Bamba-cho, Chuo-ku, Osaka City, 540-0007, Osaka, Japan
| | - Hideyuki Maeda
- Osaka Prefectural Office of Medical Examiner, 1-6 Bamba-cho, Chuo-ku, Osaka City, 540-0007, Osaka, Japan
- Department of Legal Medicine, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
| | - Eiichi Morii
- Department of Diagnostic Pathology, Osaka University Hospital, Suita City, Osaka, Japan
- Department of Pathology, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
| |
Collapse
|
2
|
Yoshifuji A, Nakahara S, Oyama E, Kobayashi R, Shimizu M, Sakamoto A, Yamane E, Nishida M, Shima T, Sugawara Y, Kikuchi T, Nakazawa A, Ryuzaki M, Sekine K. Managing Interhospital Referrals During a COVID-19 Patient Surge in Japan: Creating Available Beds by Exchanging Patients. Health Secur 2023. [PMID: 37093031 DOI: 10.1089/hs.2022.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
A COVID-19 patient surge in Japan from July to September 2021 caused a mismatch between patient severity and bed types because hospital beds were fully occupied and patient referrals between hospitals stagnated. Japan's predominantly private healthcare system lacks effective mechanisms to coordinate healthcare providers to address the mismatch. To address the surge, in August 2021, Tokyo Saiseikai Central Hospital started a scheme to exchange patients with other hospitals to mitigate the mismatch. In this article, we outline a retrospective observational study using medical records from a tertiary care medical center that treated severe COVID-19 cases. We describe daily patient admissions to our hospital's COVID-19 beds from July to September 2021, and compared the moving average of daily admissions before and after the exchange scheme was introduced. Bed occupancy reached nearly 100% in late July when the patient surge began and continued to exceed 100% in August when the surge peaked. However, the average daily admission did not decrease in August compared with July: the median daily admission (25th to 75th percentile) during each period was 2 (1 to 2.5) in late July and 3 (2 to 4) in August. The number of patients referred in from secondary care hospitals and the number of patients referred out was balanced in August. During the patient surge, the exchange scheme enabled the hospital to maintain and even increase the number of new admissions despite the bed shortage. Coordinating patient referrals in both directions simultaneously, rather than the usual 1-way transfer, can mitigate such mismatches.
Collapse
Affiliation(s)
- Ayumi Yoshifuji
- Ayumi Yoshifuji, MD, PhD is Staff, Division of Nephrology, Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Shinji Nakahara
- Shinji Nakahara, MD, MS, PhD, is a Professor, Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Emi Oyama
- Emi Oyama is Staff, Division of Nephrology, Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Risa Kobayashi
- Risa Kobayashi, RN, is Staff, Department of Nursing, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Mao Shimizu
- Mao Shimizu, RN, is Staff, Department of Nursing, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Akemi Sakamoto
- Akemi Sakamoto, RN, is Staff, Division of Infection Control, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Eri Yamane
- Eri Yamane, RN, is Staff, Division of Infection Control, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Masamichi Nishida
- Masamichi Nishida, MD, PhD, is Director, Department of Emergency Medicine, NTT Medical Center Tokyo, Tokyo, Japan
| | - Tamotsu Shima
- Tamotsu Shima, MD, is Chief Physician, Department of Emergency, Toranomon Hospital, Tokyo, Japan
| | - Yoko Sugawara
- Yoko Sugawara, MD, is Staff, Department of Emergency and Critical Care Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Takahide Kikuchi
- Takahide Kikuchi, MD, is Director, Division of Hematology, Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Atsushi Nakazawa
- Atsushi Nakazawa, MD, PhD, is Director, Division of Gastroenterology, Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Munekazu Ryuzaki
- Munekazu Ryuzaki, MD, PhD, is Director, Division of Nephrology, Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Kazuhiko Sekine
- Kazuhiko Sekine, MD, PhD, is Director, Department of Emergency and Critical Care Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| |
Collapse
|