The Effects of Temperature on Accident and Emergency Department Attendances in London: A Time-Series Regression Analysis

Hotz, Ines Corcuera; Hajat, Shakoor

doi:10.3390/ijerph17061957

Cited by 19 publications

(20 citation statements)

References 29 publications

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“…Our results are broadly consistent with the limited number of prior studies that suggest that heat is associated with higher risk of ED visits, hospitalizations, and ambulance dispatches among children ( Corcuera Hotz and Hajat 2020 ; Sheffield et al. 2018 ; van Loenhout et al.…”

Section: Discussionsupporting

confidence: 91%

Warm Season and Emergency Department Visits to U.S. Children’s Hospitals

Bernstein

Sun

Weinberger

et al. 2022

Environ Health Perspect

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Background: Extreme heat exposures are increasing with climate change. Health effects are well documented in adults, but the risks to children are not well characterized. Objectives: We estimated the association between warm season (May to September) temperatures and cause-specific emergency department (ED) visits among U.S. children and adolescents. Methods: This multicenter time-series study leveraged administrative data on ED visits by children and adolescents of age to the EDs of 47 U.S. children’s hospitals from May to September from 2016 to 2018. Daily maximum ambient temperature was estimated in the county of the hospital using a spatiotemporal model. We used distributed-lag nonlinear models with a quasi-Poisson distribution to estimate the association between daily maximum temperature and the relative risk (RR) of ED visits, adjusting for temporal trends. We then used a random-effects meta-analytic model to estimate the overall cumulative association. Results: Extreme heat was associated with an RR of all-cause ED visits of 1.17 (95% CI: 1.12, 1.21) relative to hospital-specific minimum morbidity temperature. Associations were more pronounced for ED visits due to heat-related illness including dehydration and electrolyte disorders ( 1.83; 95% CI: 1.31, 2.57), bacterial enteritis (1.35; 95% CI: 1.02, 1.79), and otitis media and externa (1.30; 95% CI: 1.11, 1.52). Taken together, temperatures above the minimum morbidity temperature accounted for an estimated 11.8% [95% empirical 95% confidence interval (eCI): 9.9%, 13.3%] of warm season ED visits for any cause and 31.0% (95% eCI: 17.9%, 36.5%) of ED visits for heat-related illnesses. Conclusion: During the warm season, days with higher temperatures were associated with higher rates of visits to children’s hospital EDs. Higher ambient temperatures may contribute to a significant proportion of ED visits among U.S. children and adolescents. https://doi.org/10.1289/EHP8083

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Section: Discussionsupporting

confidence: 91%

Warm Season and Emergency Department Visits to U.S. Children’s Hospitals

Bernstein

Sun

Weinberger

et al. 2022

Environ Health Perspect

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“…Four of the five systematic reviews also completed meta-analysis [ 16 , 23 , 24 , 25 ]. Of the remaining 17 studies, the majority utilized either a case-crossover design with conditional logistic regression [ 26 , 27 , 28 ], time series analysis utilizing Poisson regression [ 29 , 30 , 31 , 32 , 33 , 34 ], distributed lag nonlinear models [ 35 ], or generalized additive models [ 36 ]. Poisson regression and generalized linear regression [ 37 , 38 ], multiple stepwise regression analysis [ 39 ], canonical correlation analysis [ 40 ], and t -test [ 41 , 42 ] were also conducted.…”

Section: Resultsmentioning

confidence: 99%

“…The five systematic reviews included studies from North America, Europe, Asia, and Australia. Single studies were conducted in the United States [ 26 , 27 , 28 , 29 , 33 , 40 , 41 ], Canada [ 34 , 35 , 36 , 37 ], Southern Europe [ 31 , 38 , 39 ], Northern Europe [ 30 , 32 ], and Eastern Europe [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Studies varied in how temperature exposure was defined and measured. Out of twenty-two studies, nine examined the effect of ambient air temperature, three used average ambient temperature [ 27 , 32 , 36 ], one maximum ambient temperature [ 37 ], and four minimum, average, and maximum ambient temperatures [ 22 , 24 , 25 , 38 ]. One study examined the effects of atmospheric temperature [ 39 ].…”

Section: Resultsmentioning

confidence: 99%

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High Temperatures and Cardiovascular-Related Morbidity: A Scoping Review

Cicci

Maltby

Clemens

et al. 2022

IJERPH

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The primary objective of this review was to synthesize studies assessing the relationships between high temperatures and cardiovascular disease (CVD)-related hospital encounters (i.e., emergency department (ED) visits or hospitalizations) in urban Canada and other comparable populations, and to identify areas for future research. Ovid MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, and Scopus were searched between 6 April and 11 April 2020, and on 21 March 2021, to identify articles examining the relationship between high temperatures and CVD-related hospital encounters. Studies involving patients with pre-existing CVD were also included. English language studies from North America and Europe were included. Twenty-two articles were included in the review. Studies reported an inconsistent association between high temperatures and ischemic heart disease (IHD), heart failure, dysrhythmia, and some cerebrovascular-related hospital encounters. There was consistent evidence that high temperatures may be associated with increased ED visits and hospitalizations related to total CVD, hyper/hypotension, acute myocardial infarction (AMI), and ischemic stroke. Age, sex, and gender appear to modify high temperature-CVD morbidity relationships. Two studies examined the influence of pre-existing CVD on the relationship between high temperatures and morbidity. Pre-existing heart failure, AMI, and total CVD did not appear to affect the relationship, while evidence was inconsistent for pre-existing hypertension. There is inconsistent evidence that high temperatures are associated with CVD-related hospital encounters. Continued research on this topic is needed, particularly in the Canadian context and with a focus on individuals with pre-existing CVD.

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“…Although such studies exist on forecasting ED arrivals before the pandemic [ 9 ], much of the variation in ED arrivals remains unaccounted for, and model derivation during surges in patient encounters is lacking [ 10 ]. Furthermore, it is well established in literature that climatic variables, such as temperature, can affect the health of a community, leading to an increase in ED patient arrivals and hospital admissions [ 11 , 12 , 13 , 14 ]. There is a need to understand if climatic variables significantly affect patient arrivals during the pandemic.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Univariate and Multivariate Forecasting Models Predicting Emergency Department Patient Arrivals during the COVID-19 Pandemic

et al. 2022

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The COVID-19 pandemic has heightened the existing concern about the uncertainty surrounding patient arrival and the overutilization of resources in emergency departments (EDs). The prediction of variations in patient arrivals is vital for managing limited healthcare resources and facilitating data-driven resource planning. The objective of this study was to forecast ED patient arrivals during a pandemic over different time horizons. A secondary objective was to compare the performance of different forecasting models in predicting ED patient arrivals. We included all ED patient encounters at an urban teaching hospital between January 2019 and December 2020. We divided the data into training and testing datasets and applied univariate and multivariable forecasting models to predict daily ED visits. The influence of COVID-19 lockdown and climatic factors were included in the multivariable models. The model evaluation consisted of the root mean square error (RMSE) and mean absolute error (MAE) over different forecasting horizons. Our exploratory analysis illustrated that monthly and weekly patterns impact daily demand for care. The Holt–Winters approach outperformed all other univariate and multivariable forecasting models for short-term predictions, while the Long Short-Term Memory approach performed best in extended predictions. The developed forecasting models are able to accurately predict ED patient arrivals and peaks during a surge when tested on two years of data from a high-volume urban ED. These short- and long-term prediction models can potentially enhance ED and hospital resource planning.

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The Effects of Temperature on Accident and Emergency Department Attendances in London: A Time-Series Regression Analysis

Cited by 19 publications

References 29 publications

Warm Season and Emergency Department Visits to U.S. Children’s Hospitals

Warm Season and Emergency Department Visits to U.S. Children’s Hospitals

High Temperatures and Cardiovascular-Related Morbidity: A Scoping Review

A Comparison of Univariate and Multivariate Forecasting Models Predicting Emergency Department Patient Arrivals during the COVID-19 Pandemic

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