Abstract P069: Heat, Heat Waves and Hospital Admissions in Indianapolis, Indiana

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Yi Wang
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Relative Risk ◽  
Heat Wave ◽  
Hospital Admissions ◽  
Heat Waves ◽  
Global Climate ◽  
Extreme Heat ◽  
Apparent Temperature ◽  
The Impact

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.

scholarly journals The impact of extreme heat events on hospital admissions to the Royal Hobart Hospital

2019 ◽  
Vol 42 (2) ◽  
pp. 333-339 ◽  
Author(s):  
Kaitlyn E Watson ◽  
Kyle M Gardiner ◽  
Judith A Singleton
Keyword(s):  
Relative Risk ◽  
Linear Model ◽  
Hospital Admissions ◽  
Peak Effect ◽  
Extreme Heat ◽  
Distributed Lag ◽  
Extreme Heat Events ◽  
Preventative Health ◽  
Health Initiatives ◽  
The Impact

Abstract Background Extreme heat (EH) events are increasing in frequency and duration and cause more deaths in Australia than any other extreme weather event. Consequently, EH events lead to an increase in the number of patient presentations to hospitals. Methods Climatic observations for Hobart’s region and Royal Hobart Hospital (RHH) emergency department admissions data were collected retrospectively for the study period of 2003–2010. A distributed lag non-linear model (DLNM) was fitted using a generalized linear model with quasi-Poisson family to obtain adjusted estimates for the relationship between temperature and the relative risk of being admitted to the RHH. Results The model demonstrated that relative to the annual mean temperature of 14°C, the relative risk of being admitted to the RHH for the years 2003–2010 was significantly higher for all temperatures above 27°C (P < 0.05 in all cases). The peak effect upon admission was noted on the same day as the EH event, however, the model suggests that a lag effect exists, increasing the likelihood of admission to the RHH for a further 14 days. Conclusions To relieve the added burden on emergency departments during these events, adaptation strategies adopted by public health organizations could include preventative health initiatives.

scholarly journals Forecasting West African Heat Waves at Subseasonal and Seasonal Time Scales

2018 ◽  
Vol 146 (3) ◽  
pp. 889-907 ◽  
Author(s):  
Lauriane Batté ◽  
Constantin Ardilouze ◽  
Michel Déqué
Keyword(s):  
Heat Wave ◽  
Climate Model ◽  
Heat Waves ◽  
Global Climate ◽  
Global Climate Model ◽  
Research Programme ◽  
Relevant Information ◽  
Apparent Temperature ◽  
Increased Risk ◽  
Seasonal Time Scale

Abstract Early indication of an increased risk of extremely warm conditions could help alleviate some of the consequences of severe heat waves on human health. This study focuses on boreal spring heat wave events over West Africa and the Sahel and examines the long-range predictability and forecast quality of these events with two coupled forecasting systems designed at Météo-France, both based on the CNRM-CM coupled global climate model: the operational seasonal forecasting System 5 and the experimental contribution to the World Weather Research Programme/World Climate Research Programme (WWRP/WCRP) subseasonal-to-seasonal (S2S) project. Evaluation is based on past reforecasts spanning 22 years, from 1993 to 2014, compared to reference data from reanalyses. On the seasonal time scale, skill in reproducing interannual anomalies of heat wave duration is limited at a gridpoint level but is significant for regional averages. Subseasonal predictability of daily humidity-corrected apparent temperature drops sharply beyond the deterministic range. In addition to reforecast skill measures, the analysis of real-time forecasts for 2016, both in terms of anomalies with respect to the reforecast climatology and using a weather-type approach, provides additional insight on the systems’ performance in giving relevant information on the possible occurrence of such events.

scholarly journals Heat Waves in the City of Gaziantep in Turkey

2017 ◽  
Vol 6 (1) ◽  
pp. 131
Author(s):  
Gülşen Kum
Keyword(s):  
Climate Change ◽  
Heat Waves ◽  
Global Climate ◽  
Thermal Conditions ◽  
Apparent Temperature ◽  
Heat Index ◽  
Index Method ◽  
Temperature Method ◽  
The Impact ◽  
The City

In this study, the duration, frequency and the impact of heat waves on comfort conditions, experienced particularly in the summers, have been examined with the purpose of revealing how the annual and monthly temperatures in Gaziantep, a city located in the South Eastern district of Turkey, are affected by the global climate change. Initially, the data on minimum, maximum and average heat in the period from 1940 to 2015, retrieved from the Meteorological Station in the city center, were analyzed using the Mann-Kendall trend analysis, which is a non-parametric test, and the increase/decrease trends in temperature parameters were determined. Afterwards, the impact of heat waves on the comfort levels was demonstrated using the ''Heat Index (apparent temperature)'' method by Steadman (1979), analyzing the heat waves that are predicted to increase in rate and frequency with the climate change, even though the statistical distributions remain the same. According to the results produced by the Heat Index method, it is estimated that the temperatures in the region will shift towards a warmer climate in terms of thermal conditions. It is believed that this study will be highly instrumental in prompting necessary precautions to avert the heat waves reaching a disaster level in Gaziantep, which is located in a position susceptible to heat waves due to its latitude and geographical conditions.

scholarly journals Association of Summer Heat Waves and the Probability of Preterm Birth in Minnesota: An Exploration of the Intersection of Race and Education

2020 ◽  
Vol 17 (17) ◽  
pp. 6391
Author(s):  
M. Luke Smith ◽  
Rachel R. Hardeman
Keyword(s):  
Preterm Birth ◽  
Relative Risk ◽  
Heat Wave ◽  
White Women ◽  
Heat Waves ◽  
Maternal Risk ◽  
College Degrees ◽  
Summer Heat ◽  
Race Ethnicity ◽  
The Impact

Preterm birth (PTB) is common and has negative impacts on infant health. While some maternal risk factors have been identified, including age under 20 or over 40, substance abuse, low BMI, and racism, less is known about the impact of environmental exposures like high heat. We combined 154,157 records of live births occurring in Minnesota between 2009 and 2015 with hourly weather records collected from the Minneapolis–St. Paul airport. We tested if maternal heat wave exposure (a seven-day period with a mean daily high temp of 37 °C) immediately prior to birth leads to a higher risk of preterm birth. Additional covariates included maternal age, race/ethnicity, educational status, and residence in the seven-county Minneapolis–St. Paul metro area. Pregnant women exposed to a seven-day heat wave of 37 °C or higher experienced a higher relative risk of PTB compared to women who did not experience a heat wave (1.14 risk ratio (RR), 1.0–1.3 95% confidence interval (CI)). The result is robust to controls for a woman’s age, race/ethnicity, educational attainment, place of residence, and year of the birth. Children born to Black women with college degrees who are exposed to heat waves experience a higher relative risk of PTB compared to White women with college degrees in a heat wave (2.97 RR, 1.5–6.1 95% CI). Summer heat waves are associated with higher risk of PTB in late-term pregnancies in Minnesota.

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

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.

scholarly journals Cardiovascular risk after hospitalisation for unexplained syncope and orthostatic hypotension

Heart ◽  
2017 ◽  
Vol 104 (6) ◽  
pp. 487-493 ◽  
Author(s):  
Ekrem Yasa ◽  
Fabrizio Ricci ◽  
Martin Magnusson ◽  
Richard Sutton ◽  
Sabina Gallina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Orthostatic Hypotension ◽  
Cardiovascular Events ◽  
Hospital Admissions ◽  
Cox Regression ◽  
All Cause Mortality ◽  
Unexplained Syncope ◽  
The Impact

ObjectiveTo investigate the relationship of hospital admissions due to unexplained syncope and orthostatic hypotension (OH) with subsequent cardiovascular events and mortality.MethodsWe analysed a population-based prospective cohort of 30 528 middle-aged individuals (age 58±8 years; males, 40%). Adjusted Cox regression models were applied to assess the impact of unexplained syncope/OH hospitalisations on cardiovascular events and mortality, excluding subjects with prevalent cardiovascular disease.ResultsAfter a median follow-up of 15±4 years, 524 (1.7%) and 504 (1.7%) participants were hospitalised for syncope or OH, respectively, yielding 1.2 hospital admissions per 1000 person-years for each diagnosis. Syncope hospitalisations increased with age (HR, per 1 year: 1.07, 95% CI 1.05 to 1.09), higher systolic blood pressure (HR, per 10 mm Hg: 1.06, 95% CI 1.01 to 1.12), antihypertensive treatment (HR: 1.26, 95% CI 1.00 to 1.59), use of diuretics (HR: 1.77, 95% CI 1.31 to 2.38) and prevalent cardiovascular disease (HR: 1.59, 95% CI 1.14 to 2.23), whereas OH hospitalisations increased with age (HR: 1.11, 95% CI 1.08 to 1.12) and prevalent diabetes (HR: 1.82, 95% CI 1.23 to 2.70). After exclusion of 1399 patients with prevalent cardiovascular disease, a total of 473/464 patients were hospitalised for unexplained syncope/OH before any cardiovascular event. Hospitalisation for unexplained syncope predicted coronary events (HR: 1.85, 95% CI 1.49 to 2.30), heart failure (HR: 2.24, 95% CI 1.65 to 3.04), atrial fibrillation (HR: 1.84, 95% CI 1.50 to 2.26), aortic valve stenosis (HR: 2.06, 95% CI 1.28 to 3.32), all-cause mortality (HR: 1.22, 95% CI 1.09 to 1.37) and cardiovascular death (HR: 1.72, 95% CI 1.23 to 2.42). OH-hospitalisation predicted stroke (HR: 1.66, 95% CI 1.24 to 2.23), heart failure (HR: 1.78, 95% CI 1.21 to 2.62), atrial fibrillation (HR: 1.89, 95% CI 1.48 to 2.41) and all-cause mortality (HR: 1.14, 95% CI 1.01 to 1.30).ConclusionsPatients discharged with the diagnosis of unexplained syncope or OH show higher incidence of cardiovascular disease and mortality with only partial overlap between these two conditions.

scholarly journals The Impact of the Urban Heat Island during an Intense Heat Wave in Oklahoma City

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Jeffrey B. Basara ◽  
Heather G. Basara ◽  
Bradley G. Illston ◽  
Kenneth C. Crawford
Keyword(s):  
Urban Heat Island ◽  
Heat Wave ◽  
Rural Areas ◽  
Oklahoma City ◽  
Apparent Temperature ◽  
Heat Island ◽  
Atmospheric Conditions ◽  
Urban Heat ◽  
The Impact ◽  
Intense Heat

During late July and early August 2008, an intense heat wave occurred in Oklahoma City. To quantify the impact of the urban heat island (UHI) in Oklahoma City on observed and apparent temperature conditions during the heat wave event, this study used observations from 46 locations in and around Oklahoma City. The methodology utilized composite values of atmospheric conditions for three primary categories defined by population and general land use: rural, suburban, and urban. The results of the analyses demonstrated that a consistent UHI existed during the study period whereby the composite temperature values within the urban core were approximately C warmer during the day than the rural areas and over C warmer at night. Further, when the warmer temperatures were combined with ambient humidity conditions, the composite values consistently revealed even warmer heat-related variables within the urban environment as compared with the rural zone.

scholarly journals Culprit vessel: impact on short-term and long-term prognosis in patients with ST-elevation myocardial infarction

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000852 ◽  
Author(s):  
Artin Entezarjou ◽  
Moman Aladdin Mohammad ◽  
Pontus Andell ◽  
Sasha Koul
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
High Risk ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Clinical Event ◽  
Left Ventricular Ejection ◽  
Increased Risk ◽  
St Elevation ◽  
The Impact

BackgroundST-elevation myocardial infarction (STEMI) occurs as a result of rupture of an atherosclerotic plaque in the coronary arteries. Limited data exist regarding the impact of culprit coronary vessel on hard clinical event rates. This study investigated the impact of culprit vessel on outcomes after primary percutaneous coronary intervention (PCI) of STEMI.MethodsA total of 29 832 previously cardiac healthy patients who underwent primary PCI between 2003 and 2014 were prospectively included from the Swedish Coronary Angiography and Angioplasty Registry and the Registry of Information and Knowledge about Swedish Heart Intensive care Admissions. Patients were stratified into three groups based on culprit vessel (right coronary artery (RCA), left anterior descending artery (LAD) and left circumflex artery (LCx)). The primary outcome was 1-year mortality. The secondary outcomes included 30-day and 5-year mortality, as well as heart failure, stroke, bleeding and myocardial reinfarction at 30 days, 1 year and 5 years. Univariable and multivariable analyses were done using Cox regression models.ResultsOne-year analyses revealed that LAD infarctions had the highest increased risk of death, heart failure and stroke compared with RCA infarctions, which had the lowest risk. Sensitivity analyses revealed that reduced left ventricular ejection fraction on discharge partially explained this increased relative risk in mortality. Furthermore, landmark analyses revealed that culprit vessel had no significant influence on 1-year mortality if a patient survived 30 days after myocardial infarction. Subgroup analyses revealed female sex and multivessel disease (MVD) as significant high-risk groups with respect to 1-year mortality.ConclusionsLAD and LCx infarctions had a relatively higher adjusted mortality rate compared with RCA infarctions, with LAD infarctions in particular being associated with an increased risk of heart failure, stroke and death. Culprit vessel had limited influence on mortality after 1 month. High-risk patient groups include LAD infarctions in women or with concomitant MVD.

Abstract P84: The Impact of a Potential Nationwide Comprehensive Smoking Ban on Acute Myocardial Infarction Hospitalizations

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Mouaz H Al-Mallah ◽  
Owais Khawaja ◽  
Fadi Alqaisi ◽  
David Nerenz ◽  
W Douglas Weaver
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Cost Savings ◽  
Smoking Ban ◽  
Disease States ◽  
Established Risk Factor ◽  
Department Of Health ◽  
The Impact

Introduction: Smoking is a well established risk factor for acute myocardial infarction (AMI). The potential impact of a nationwide comprehensive smoking ban (CSB) legislation on the incidence of AMI hospital admissions is not known. The aim of this analysis is to determine the impact of a nationwide CSB legislation on the incidence of AMI hospitalizations. Methods: We contacted the department of health at states with no CSB law for information on the total number of AMI discharges (ICD-9-CM 410), length of stay and charges in dollars for 2007. Expected decrease in the number of AMI in the year following a potential implementation of a nationwide CSB was calculated by multiplying the current number of AMI by the pooled relative risk reduction (RRR) obtained from a recent published meta analysis (RR 0.89). Results: In 2007, 37 States had CSB laws. There were 169,043 AMI hospitalizations in states without CSB. A nationwide smoking ban would result in 18,596 less AMI hospitalizations in the year following such a ban. This is associated with more than 92 million dollars in direct cost savings. Conclusion: A nationwide CSB legislation would result in significant reduction in the number of AMI hospitalizations. This is associated with significant cost saving. Further studies are needed to evaluate the impact of CSB on admission from other disease states.

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