Heat Illness: Predictors of Hospital Admissions Among Emergency Department Visits—Georgia, 2002–2008

Abstract

Heat-related illnesses (HRI) are the most frequent cause of environmental exposure-related injury treated in US emergency departments (ED). While most individuals with HRI evaluated in EDs are discharged to home, understanding predictors of individuals hospitalized with HRI may help public health practitioners and medical providers identify high risk groups who would benefit from educational outreach. We analyzed data collected by the Georgia Department of Public Health, Office of Health Indicators for Planning, regarding ED and hospital discharges for HRI, as identified by ICD-9 codes, between 2002 and 2008 to determine characteristics of individuals receiving care in EDs. Temperature data from CDC's Environmental Public Health Tracking Network were linked to the dataset to determine if ED visits occurred during an extreme heat event (EHE). A multivariable logistic regression model was developed to determine characteristics predicting hospitalization versus ED discharge using demographic characteristics, comorbid conditions, socioeconomic status, the public health district of residence, and the presence of an EHE. Men represented the majority of ED visits (75 %) and hospitalizations (78 %). In the multivariable model, the odds of admission versus ED discharge with an associated HRI increased with age among both men and women, and odds were higher among residents of specific public health districts, particularly in the southern part of the state. Educational efforts targeting the specific risk groups identified by this study may help reduce the burden of hospitalization due to HRI in the state of Georgia.

Development and validation of an admission prediction tool for emergency departments in the Netherlands

“…In the past, multiple studies studied factors predicting hospitalisation for patients in the ED. However, most of these studies concentrated on specific diseases, often chronic obstructive pulmonary disease,4 6 10 14 but also fractures,7 8 15 allergic reactions to food,2 syncope,5 heat illness,9 urinary tract infections,11 transient ischaemic attacks12 and soft tissue infections in injection drug users 13. These studies found that patients admitted to the hospital were older,4 8–12 14 more frequently arrived by ambulance,2 4 more frequently were triaged in urgent categories4 6 10 and had more comorbidities 5 8 9 12 14.…”

Racial and Socioeconomic Disparities in Heat-Related Health Effects and Their Mechanisms: a Review

“…However, some studies have not found race or ethnicity to be associated with heat-associated health effects [53-55], and in a study of high temperatures and emergency room visits for various cardio-respiratory diseases in California, as compared to whites, risks were higher among Hispanics for some diseases and lower among blacks, Hispanics or Asians for others [56]. These studies largely did not control for other characteristics of vulnerability.…”

“…A study in Georgia, U.S., found middle but not lower socioeconomic status, as defined by family structure, housing, education and employment in a census block group, to be associated with increased emergency department admissions for heat illnesses. [55] A study in Hong Kong found increased vulnerability among people living in low socioeconomic districts. [69] In Phoenix, Arizona, neighborhood socioeconomic vulnerability was an important predictor of heat-related death in a census block group.…”

Gender- and Sex-specific Sports-related Injury Research in Emergency Medicine: A Consensus on Future Research Direction and Focused Application

“…Despite higher risk of injury in women at a given temperature threshold, men are more likely to present to the ED with heat-related illness. 36 The NEISS-All Injury Surveillance program found that an estimated 5,946 persons were treated in U.S. EDs each year for a heat illness sustained while participating in sports or recreational activities. Males represents 72.5% of these visits, and only 7.1% of all patients, between 15 and 19 years, were hospitalized, predominantly males.…”