scholarly journals Impact of Extremely Hot Days on Emergency Department Visits for Cardiovascular Disease among Older Adults in New York State

Author(s):  
Mengxuan Li ◽  
Benjamin A. Shaw ◽  
Wangjian Zhang ◽  
Elizabeth Vásquez ◽  
Shao Lin

Prior studies have reported the impact of ambient heat exposure on heat-related illnesses and mortality in summer, but few have assessed its effect on cardiovascular diseases (CVD) morbidity, and the association difference by demographics and season. This study examined how extremely hot days affected CVD-related emergency department (ED) visits among older adults from 2005–2013 in New York State. A time-stratified case-crossover design was used to assess the heat–CVD association in summer and transitional months (April–May and September–October). Daily mean temperature >95th percentile of regional monthly mean temperature was defined as an extremely hot day. Extremely hot days were found to be significantly associated with increased risk of CVD-related ED visits at lag day 5 (OR: 1.02, 95% CI: 1.01–1.04) and lag day 6 (OR: 1.01, 95% CI: 1.00–1.03) among older adults in summer after controlling for PM2.5 concentration, relative humidity, and barometric pressure. Specifically, there was a 7% increased risk of ischemic heart disease on the day of extreme heat, and increased risks of hypertension (4%) and cardiac dysrhythmias (6%) occurred on lag days 5 and 6, respectively. We also observed large geographic variations in the heat–CVD associations.

2017 ◽  
Vol 32 (4) ◽  
pp. 2058-2066
Author(s):  
Maria S. Altieri ◽  
Jie Yang ◽  
Chencan Zhu ◽  
Samer Sbayi ◽  
Konstantinos Spaniolas ◽  
...  

2017 ◽  
Vol 32 (3) ◽  
pp. 1209-1214 ◽  
Author(s):  
Maria S. Altieri ◽  
Jie Yang ◽  
Donald Groves ◽  
Nabeel Obeid ◽  
Jihye Park ◽  
...  

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Michael Bauer ◽  
Leah Hines ◽  
Emilia Pawlowski ◽  
Jin Luo ◽  
Anne Scott ◽  
...  

Abstract Background In New York State (NYS), motor vehicle (MV) injury to child passengers is a leading cause of hospitalization and emergency department (ED) visits in children aged 0–12 years. NYS laws require appropriate child restraints for ages 0–7 years and safety belts for ages 8 and up while traveling in a private passenger vehicle, but do not specify a seating position. Methods Factors associated with injury in front-seated (n = 11,212) compared to rear-seated (n = 93,092) passengers aged 0–12 years were examined by age groups 0–3, 4–7 and 8–12 years using the 2012–2014 NYS Crash Outcome Data Evaluation System (CODES). CODES consists of Department of Motor Vehicle (DMV) crash reports linked to ED visits and hospitalizations. The front seat was row 1 and the rear rows 2–3. Vehicle towed from scene and air bag deployed were proxies for crash severity. Injury was dichotomized based on Maximum Abbreviated Injury Severity (MAIS) scores greater than zero. Multivariable logistic regression (odds ratios (OR) with 95% CI) was used to examine factors predictive of injury for the total population and for each age group. Results Front-seated children had more frequent injury than those rear-seated (8.46% vs. 4.92%, p < 0.0001). Children in child restraints experienced fewer medically-treated injuries compared to seat belted or unrestrained children (3.80, 6.50 and 13.62%, p < 0.0001 respectively). A higher proportion of children traveling with an unrestrained vs. restrained driver experienced injury (14.50% vs 5.26%, p < 0.0001). After controlling for crash severity, multivariable adjusted predictors of injury for children aged 0–12 years included riding in the front seat (1.20, 1.10–1.31), being unrestrained vs. child restraint (2.13, 1.73–2.62), being restrained in a seat belt vs. child restraint (1.20, 1.11–1.31), and traveling in a car vs. other vehicle type (1.21, 1.14–1.28). Similarly, protective factors included traveling with a restrained driver (0.61, 0.50–0.75), a driver aged < 25 years (0.91, 0.82–0.99), being an occupant of a later vehicle model year 2005–2008 (0.68, 0.53–0.89) or 2009–2015 (0.55, 0.42–0.71) compared to older model years (1970–1993). Conclusions Compared to front-seated children, rear-seated children and children in age-appropriate restraints had lower adjusted odds of medically-treated injury.


2018 ◽  
Vol 8 (4) ◽  
pp. 166-170
Author(s):  
Jerina Nogueira ◽  
Pedro Abreu ◽  
Patrícia Guilherme ◽  
Ana Catarina Félix ◽  
Fátima Ferreira ◽  
...  

Background: The long-term prognosis of spontaneous intracerebral hemorrhage (SICH) is poor. Frequent emergency department (ED) visits can signal increased risk of hospitalization and death. There are no studies describing the risk of frequent ED visits after SICH. Methods: Retrospective cohort study of a community representative consecutive SICH survivors (2009-2015) from southern Portugal. Logistic regression analysis was performed to identify sociodemographic and clinical factors associated with frequent ED visits (≥4 visits) within the first year after hospital discharge. Results: A total of 360 SICH survivors were identified, 358 (98.6%) of whom were followed. The median age was 72; 64% were males. The majority of survivors (n = 194, 54.2%) had at least 1 ED visit. Reasons for ED visits included infections, falls with trauma, and isolated neurological symptoms. Forty-four (12.3%) SICH survivors became frequent ED visitors. Frequent ED visitors were older and had more hospitalizations ( P < .001) and ED visits ( P < .001) prior to the SICH, unhealthy alcohol use ( P = .049), longer period of index SICH hospitalization ( P = .032), pneumonia during hospitalization ( P = .001), and severe neurological impairment at discharge ( P = .001). Pneumonia during index hospitalization (odds ratio [OR]: 3.08; confidence interval [CI]: 1.39-6.76; P = .005) and history of ED visits prior to SICH (OR: 1.64; CI: 1.19-2.26, P = .003) increased the likelihood of becoming a frequent ED visitor. Conclusions: Predictors of frequent ED visits are identifiable at hospital discharge and during any ED visit. Improvement of transitional care and identification of at-risk patients may help reduce multiple ED visits.


Author(s):  
Joyce C. Pressley ◽  
Leah M. Hines ◽  
Michael J. Bauer ◽  
Shin Ah Oh ◽  
Joshua R. Kuhl ◽  
...  

Rural areas of New York State (NYS) have higher rates of alcohol-related motor vehicle (MV) crash injury than metropolitan areas. While alcohol-related injury has declined across the three geographic regions of NYS, disparities persist with rural areas having smaller declines. Our study aim was to examine factors associated with alcohol-related MV crashes in Upstate and Long Island using multi-sourced county-level data that included the Crash Outcome Data Evaluation System (CODES) with emergency department visits and hospitalizations, traffic citations, demographic, economic, transportation, alcohol outlets, and Rural–Urban Continuum Codes (RUCCS). A cross-sectional study design employed zero-truncated negative binominal regression models to assess relative risks (RR) with 95% confidence interval (CI). Counties (n = 57, 56,000 alcohol-related crashes over the 3 year study timeframe) were categorized by mean annual alcohol-related MV injuries per 100,000 population: low (24.7 ± 3.9), medium (33.9 ± 1.7) and high (46.1 ± 8.0) (p < 0.0001). In multivariable analyses, alcohol-related MV injury was elevated for non-adjacent, non-metropolitan counties (RR 2.5, 95% CI: 1.6–3.9) with higher citations for impaired driving showing a small, but significant protective effect. Less metropolitan areas had higher alcohol-related MV injury with inconsistent alcohol-related enforcement measures. In summary, higher alcohol-related MV injury rates in non-metropolitan counties demonstrated a dose–response relationship with proximity to a metropolitan area. These findings suggest areas where intervention efforts might be targeted to lower alcohol-related MV injury.


2020 ◽  
pp. 155982762094218
Author(s):  
Briana L. Moreland ◽  
Ramakrishna Kakara ◽  
Yara K. Haddad ◽  
Iju Shakya ◽  
Gwen Bergen

Introduction. Falls among older adults (age ≥65) are a common and costly health issue. Knowing where falls occur and whether this location differs by sex and age can inform prevention strategies. Objective. To determine where injurious falls that result in emergency department (ED) visits commonly occur among older adults in the United States, and whether these locations differ by sex and age. Methods. Using 2015 National Electronic Injury Surveillance System-All Injury Program data we reviewed narratives for ED patients aged ≥65 who had an unintentional fall as the primary cause of injury. Results. More fall-related ED visits (71.6%) resulted from falls that occurred indoors. A higher percentage of men’s falls occurred outside (38.3%) compared to women’s (28.4%). More fall-related ED visits were due to falls at home (79.2%) compared to falls not at home (20.8%). The most common locations for a fall at home were the bedroom, bathroom, and stairs. Conclusion. The majority of falls resulting in ED visits among older adults occurred indoors and varied by sex and age. Knowing common locations of injurious falls can help older adults and caregivers prioritize home modifications. Understanding sex and age differences related to fall location can be used to develop targeted prevention messages.


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