Abstract
Background: The association between diurnal temperature range (DTR) and hospitalization for exacerbation of chronic respiratory diseases (CRD) was rarely reported. Objectives: To examine the association between DTR and daily hospital admission for exacerbations of CRD and find out the potential effect of modifications on this association.Method: Data on daily hospitalization for exacerbation of chronic obstructive pulmonary disease (COPD), asthma and bronchiectasis and meteorology measures from 2013 through 2017 were obtained from 21 cities in South China. After controlling the effects of daily mean temperature, relative humidity (RH), particulate matter < 2.5 µm diameter (PM2.5) and other confounding factors, a standard generalized additive model (GAM) with a quasi-Poisson distribution was performed to evaluate the relationships between DTR and daily hospital admissions of CRD in a two-stage strategy. Subgroup analysis was performed to find potential modifications, including seasonality and population characteristics.Result: Elevated risk of hospitalization for exacerbation of CRD (RR=1.09 [95%CI: 1.08 to 1.11]) was associated with interquartile range (IQR) increase in DTR. The effects of DTR on hospital admissions for CRD were strong at low DTR in the hot season and high DTR in the cold season. The relative risk (RR) of hospitalization was 1.11 (95%CI: 1.08 to 1.12) for exacerbations of COPD and 1.09 (95%CI: 1.05 to 1.13) for asthma per IQR increase in DTR. The adverse effect of DTR on hospitalization for bronchiectasis was only observed in female patients (RR=1.06 [95%CI: 1.03 to 1.10]). Conclusion: Our study provided additional evidence for the association between DTR and daily hospitalization for exacerbation of CRD, and these associations are especially stronger in COPD patients and in the cold season than the hot season. Preventive measures to reduce the adverse impacts of DTR were needed for CRD patients.
Factors Influencing the Cold-Season Diurnal Temperature Range in the United States
