The Impact of Heat, Cold, and Heat Waves on Hospital Admissions in 8 Cities in Korea

Background: The association between heat and hospital admissions is well studied, but in Indiana where the regulatory agencies cites lack of evidence for global climate change, local evidence of such an association is critical for Indiana to mitigate the impact of increasing heat. Methods: Using a distributed-lag non-linear model, we studied the effects of moderate (31.7 °C or 90 th percentile of daily mean apparent temperature (AT)), severe (33.5 °C or 95 th percentile of daily mean apparent temperature (AT)) and extreme (36.4 °C or 99 th percentile of AT) heat on hospital admissions (June-August 2007-2012) for cardiovascular (myocardial infarction, myocardial infarction, heart failure) and heat-related diseases in Indianapolis, Indiana located in Marion County. We also examined the added effects of moderate heat waves (AT above the 90 th percentile lasting 2-6 days), severe heat waves (AT above the 95 th percentile lasting 2-6 days) and extreme heat waves (AT above the 99 th percentile lasting 2-6 days). In sensitivity analysis, we tested robustness of our results to 1) different temperature and lag structures and 2) temperature metrics (daily min, max and diurnal temperature range). Results: The relative risks of moderate heat, relative to 29.2°C (75 th percentile of AT), on admissions for cardiovascular disease (CVD), myocardial infarction (MI), heart failure (HF), and heat-related diseases (HD) were 0.98 (0.67, 1.44), 6.28 (1.48, 26.6), 1.38 (0.81, 2.36) and 1.73 (0.58, 5.11). The relative risk of severe heat on admissions for CVD, MI, HF, and HD were 0.93 (0.60, 1.43), 4.46 (0.85, 23.4), 1.30 (0.72, 2.34) and 2.14 (0.43, 10.7). The relative risk of extreme heat were 0.79 (0.26, 2.39), 0.11 (0.087, 1.32), 0.68 (0.18, 2.61), and 0.32 (0.005, 19.5). We also observed statistically significant added effects of moderate heat waves lasting 4 or 6 days on hospital admission for MI and HD and extreme heat waves lasting 4 days on hospital admissions for HD. Results were strengthened for people older than 65. Conclusions: Moderate heat wave lasting 4-6 days were associated with increased hospital admissions for MI and HD diseases and extreme heat wave lasting 4 days were associated with increased admissions for HD.

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Impairments to Thermoregulation in the Elderly During Heat Exposure Events

Gerontology and Geriatric Medicine ◽

10.1177/2333721420932432 ◽

2020 ◽

Vol 6 ◽

pp. 233372142093243

Author(s):

Alison Millyard ◽

Joe D. Layden ◽

David B. Pyne ◽

Andrew M. Edwards ◽

Saul R. Bloxham

Keyword(s):

Hospital Admissions ◽

Heat Waves ◽

Heat Exposure ◽

The Elderly ◽

Physiological Strain ◽

Reducing Ability ◽

Health Related ◽

Heat Perception ◽

Wave Induced ◽

The Impact

Heat waves represent a public health risk to elderly people, and typically result in an increased rate of hospital admissions and deaths. Studies of thermoregulation in this cohort have generally focused on single elements such as sweating capacity. Sweating capacity and skin blood flow reduce with age, reducing ability to dissipate heat. Perception of effort during heat exposure is emerging as an area that needs further investigation as the elderly appear to lack the ability to adequately perceive increased physiological strain during heat exposure. The role of the gut and endotoxemia in heat stress has received attention in young adults, while the elderly population has been neglected. This shortcoming offers another potential avenue for identifying effective integrated health interventions to reduce heat illnesses. Increasing numbers of elderly individuals in populations worldwide are likely to increase the incidence of heat wave-induced deaths if adequate interventions are not developed, evaluated, and implemented. In this narrative-style review we identify and discuss health-related interventions for reducing the impact of heat illnesses in the elderly.

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The impact of heat, cold, and heat waves on hospital admissions in eight cities in Korea

International Journal of Biometeorology ◽

10.1007/s00484-014-0791-y ◽

2014 ◽

Vol 58 (9) ◽

pp. 1893-1903 ◽

Cited By ~ 45

Author(s):

Ji-Young Son ◽

Michelle L. Bell ◽

Jong-Tae Lee

Keyword(s):

Hospital Admissions ◽

Heat Waves ◽

The Impact

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The impact of paliperidone palmitate long acting injection on hospital admissions in a mental health setting

10.26226/morressier.5785edcdd462b80296c99bf6 ◽

2016 ◽

Author(s):

Natalie Page

Keyword(s):

Mental Health ◽

Hospital Admissions ◽

Paliperidone Palmitate ◽

Mental Health Setting ◽

Long Acting ◽

The Impact

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Diabetes Discharge Planning and Transitions of Care: A Focused Review

Current Diabetes Reviews ◽

10.2174/1573399814666180711120830 ◽

2019 ◽

Vol 15 (2) ◽

pp. 111-117 ◽

Cited By ~ 9

Author(s):

Robin L. Black ◽

Courtney Duval

Keyword(s):

Patient Outcomes ◽

Hospital Admissions ◽

Discharge Planning ◽

Medication Management ◽

Hospital Readmissions ◽

The United States ◽

Transitions Of Care ◽

Discharge Process ◽

The Impact ◽

Diabetes Patients

Background: Diabetes is a growing problem in the United States. Increasing hospital admissions for diabetes patients demonstrate the need for evidence-based care of diabetes patients by inpatient providers, as well as the importance of continuity of care when transitioning patients from inpatient to outpatient providers. Methods: A focused literature review of discharge planning and transitions of care in diabetes, conducted in PubMed is presented. Studies were selected for inclusion based on content focusing on transitions of care in diabetes, risk factors for readmission, the impact of inpatient diabetes education on patient outcomes, and optimal medication management of diabetes during care transitions. American Diabetes Association (ADA) guidelines for care of patients during the discharge process are presented, as well as considerations for designing treatment regimens for a hospitalized patient transitioning to various care settings. Results: Multiple factors may make transitions of care difficult, including poor communication, poor patient education, inappropriate follow-up, and clinically complex patients. ADA recommendations provide guidance, but an individualized approach for medication management is needed. Use of scoring systems may help identify patients at higher risk for readmission. Good communication with patients and outpatient providers is needed to prevent patient harm. A team-based approach is needed, utilizing the skills of inpatient and outpatient providers, diabetes educators, nurses, and pharmacists. Conclusion: Structured discharge planning per guideline recommendations can help improve transitions in care for patients with diabetes. A team based, patient-centered approach can help improve patient outcomes by reducing medication errors, delay of care, and hospital readmissions.

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Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01779-9 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Antonio Leon-Justel ◽

Jose I. Morgado Garcia-Polavieja ◽

Ana Isabel Alvarez-Rios ◽

Francisco Jose Caro Fernandez ◽

Pedro Agustin Pajaro Merino ◽

...

Keyword(s):

Heart Failure ◽

Hospital Admissions ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Secondary Outcome ◽

Ventricular Ejection Fraction ◽

Number Of Patients ◽

Ed Visits ◽

The Impact

Abstract Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

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The Impact of Heat Waves on Agricultural Labor Productivity and Output

Extreme Events and Climate Change ◽

10.1002/9781119413738.ch2 ◽

2021 ◽

pp. 11-20

Author(s):

Federico Castillo ◽

Armando Sánchez Vargas ◽

J. K. Gilless ◽

Michael Wehner

Keyword(s):

Labor Productivity ◽

Heat Waves ◽

Agricultural Labor ◽

Agricultural Labor Productivity ◽

The Impact

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Urban Heat Islands and Thermal Comfort: A Case Study of Zorrotzaurre Island in Bilbao

Sustainability ◽

10.3390/su13116106 ◽

2021 ◽

Vol 13 (11) ◽

pp. 6106

Author(s):

Irantzu Alvarez ◽

Laura Quesada-Ganuza ◽

Estibaliz Briz ◽

Leire Garmendia

Keyword(s):

Thermal Comfort ◽

Heat Waves ◽

Urban Environments ◽

Urban Heat Islands ◽

Extreme Weather Events ◽

Climate Index ◽

Physiological Equivalent Temperature ◽

Heat Islands ◽

The North ◽

The Impact

This study assesses the impact of a heat wave on the thermal comfort of an unconstructed area: the North Zone of the Island of Zorrotzaurre (Bilbao, Spain). In this study, the impact of urban planning as proposed in the master plan on thermal comfort is modeled using the ENVI-met program. Likewise, the question of whether the urbanistic proposals are designed to create more resilient urban environments is analyzed in the face of increasingly frequent extreme weather events, especially heat waves. The study is centered on the analysis of temperature variables (air temperature and average radiant temperature) as well as wind speed and relative humidity. This was completed with the parameters of thermal comfort, the physiological equivalent temperature (PET) and the Universal Temperature Climate Index (UTCI) for the hours of the maximum and minimum daily temperatures. The results demonstrated the viability of analyzing thermal comfort through simulations with the ENVI-met program in order to analyze the behavior of urban spaces in various climate scenarios.

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The impact of COVID-19 infection on hip fracture 30-day mortality

Trauma ◽

10.1177/1460408620949725 ◽

2021 ◽

pp. 146040862094972

Author(s):

Ahmed Fadulelmola ◽

Rob Gregory ◽

Gavin Gordon ◽

Fiona Smith ◽

Andrew Jennings

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Hospital Admissions ◽

The Elderly ◽

Primary Outcome Measure ◽

Time To Death ◽

Significant Difference ◽

The Mean ◽

The Impact ◽

Mean Time

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.

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