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Omatsu K, Uchiyama M, Shimizu U, Ling Y, Okuda S, Koyama Y. Impact of Heavy Snowfall on Emergency Transport and Prognosis of Out-of-Hospital Cardiac Arrest Patients: A Nation-Wide Cohort Study. Prehosp Disaster Med 2023; 38:436-443. [PMID: 37448197 PMCID: PMC10445114 DOI: 10.1017/s1049023x23006040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a significant global cause of mortality, and Emergency Medical Services (EMS) response interval is critical for survival and a neurologically-favorable outcome. Currently, it is unclear whether EMS response interval, neurologically-intact survival, and overall survival differ between snowy and non-snowy periods at heavy snowfall areas. METHODS A nation-wide population-based cohort of OHCA patients, registered from 2017 through 2019 in the All-Japan Utstein Registry, was divided into four groups according to areas (heavy snowfall area or other area) and seasons (winter or non-winter): heavy snowfall-winter, heavy snowfall-non-winter, other area-winter, and other area-non-winter. The first coprimary outcome was EMS response interval, and the secondary coprimary outcome was one-month survival and a neurologically-favorable outcome at one month. RESULTS A total of 337,781 OHCA patients were divided into four groups: heavy snowfall-winter (N = 15,627), heavy snowfall-non-winter (N = 97,441), other area-winter (N = 32,955), and other area-non-winter (N = 191,758). Longer EMS response intervals (>13 minutes) were most likely in the heavy snowfall-winter group (OR = 1.86; 95% CI, 1.76 to 1.97), and also more likely in heavy snowfall areas in non-winter (OR = 1.44; 95% CI, 1.38 to 1.50). One-month survival in winter was worse not only in the heavy snowfall area (OR = 0.86; 95% CI, 0.78 to 0.94) but also in other areas (OR = 0.91; 95% CI, 0.87 to 0.94). One-month neurologically-favorable outcomes were also comparable between heavy snowfall-winter and other area-non-winter groups. CONCLUSIONS This study showed OHCA in heavy snowfall areas in winter resulted in longer EMS response intervals. However, heavy snowfall had little effect on one-month survival or neurologically-favorable outcome at one month.
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Affiliation(s)
- Kentaro Omatsu
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan
- Department of Emergency Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Mieko Uchiyama
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Utako Shimizu
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Yiwei Ling
- Bioinformatics Laboratory, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shujiro Okuda
- Bioinformatics Laboratory, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yu Koyama
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan
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Tang C, Ji Y, Li Q, Yao Z, Cheng J, He Y, Liu X, Pan R, Wei Q, Yi W, Su H. Effects of different heat exposure patterns (accumulated and transient) and schizophrenia hospitalizations: a time-series analysis on hourly temperature basis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:69160-69170. [PMID: 34286435 DOI: 10.1007/s11356-021-15371-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
Growing studies have shown that high temperature is a potential risk factor of schizophrenia occurrence. Therefore, elaborate analysis of different temperature exposure patterns, such as cumulative heat exposure within a time period and transient exposure at a particular time point, is of important public health significance. This study aims to utilize hourly temperature data to better capture the effects of cumulative and transient heat exposures on schizophrenia during the warm season in Hefei, China. We included the daily mean temperature and daily schizophrenia hospitalizations into the distributed lag non-linear model (DLNM) to simulate the exposure-response curve and determine the heat threshold (19.4 °C). We calculated and applied a novel indicator-daily excess hourly heat (DEHH)-to examine the effects of cumulative heat exposure over a day on schizophrenia hospitalizations. Temperature measurements at each time point were also incorporated in the DLNM as independent exposure indicators to analyze the impact of transient heat exposure on schizophrenia. Each increment of interquartile range (IQR) in DEHH was associated with elevated risk of schizophrenia hospitalizations from lag 1 (RR = 1.036, 95% confidence interval (CI): 1.016, 1.057) to lag 4 (RR = 1.025, 95% CI: 1.005, 1.046). Men and people over 40 years old were more susceptible to DEHH. Besides, we found a greater risk of heat-related schizophrenia hospitalizations between 0 a.m. and 6 a.m. This study revealed the adverse effects of accumulated and transient heat exposures on schizophrenia hospitalizations. Our findings need to be further tested in other regions with distinct regional features.
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Affiliation(s)
- Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Yifu Ji
- Anhui Mental Health Center, Hefei, 230032, Anhui, China
| | - Qingru Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Zhenhai Yao
- Anhui Public Meteorological Service Center, Hefei, 230011, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China.
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Hayashida K, Takegawa R, Nishikimi M, Aoki T, Emoto R, Shinozaki K, Miyara SJ, Rolston DM, Li T, Shoaib M, Fukuda T, Molmenti EP, Suzuki M, Sasaki J, Matsui S, Becker LB. The interplay between bystander cardiopulmonary resuscitation and ambient temperature on neurological outcome after cardiac arrest: A nationwide observational cohort study. Resuscitation 2021; 164:46-53. [PMID: 34023426 DOI: 10.1016/j.resuscitation.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/15/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND At lower ambient temperature, patients with out-of-hospital cardiac arrest (OHCA) easily experience hypothermia. Hypothermia has shown to improve the rate of successful return of spontaneous circulation (ROSC) in animal models. We hypothesized that lower temperature affects the impact of bystander cardiopulmonary resuscitation (CPR) on the increased odds of a favorable neurological outcome post-OHCA. METHODS This study used information collected by the prospective, nationwide, Utstein registry to examine data from 352,689 adult patients who experienced OHCA from 2012 to 2016 in Japan. The primary outcome was a 1-month favorable neurological outcomes. Multivariable logistic regression analyses were conducted to test the impact of bystander CPR according to the temperature on the favorable outcome. RESULTS A total of 201,111 patients with OHCA were included in the complete case analysis. The lower temperature group had lower proportions of receiving bystander CPR (46.5 vs. 47.9%) and having favorable outcome (2.1 vs 2.8%) than those in the higher group. Multivariable analysis revealed that bystander CPR at lower temperatures was significantly associated with favorable outcomes (adjusted odds ratio, 1.22; 95% CI, 1.09-1.37), whereas bystander CPR at higher temperatures was not associated with favorable outcomes (1.02; 0.92-1.13). The nonlinear relationship using a spline curve in the multivariable model revealed that odds ratio of favorable neurological outcomes associated with bystander CPR increased as the temperature decreased. CONCLUSION Bystander CPR was associated with favorable neurological outcomes at lower temperatures. The odds of a favorable outcome associated with bystander CPR increased as the temperature decreased.
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Affiliation(s)
- Kei Hayashida
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA; Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Ryosuke Takegawa
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
| | - Mitsuaki Nishikimi
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
| | - Tomoaki Aoki
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
| | - Ryo Emoto
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koichiro Shinozaki
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Santiago J Miyara
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Daniel M Rolston
- Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Timmy Li
- Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Muhammad Shoaib
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Tatsuma Fukuda
- Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Ernesto P Molmenti
- Department of Surgery, Medicine, and Pediatrics, Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA; Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Masaru Suzuki
- Department of Emergency Medicine, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shigeyuki Matsui
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Lance B Becker
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA; Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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Kranc H, Novack V, Shtein A, Sherman R, Novack L. Extreme temperature and out-of-hospital-cardiac-arrest. Nationwide study in a hot climate country. Environ Health 2021; 20:38. [PMID: 33820550 PMCID: PMC8022396 DOI: 10.1186/s12940-021-00722-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/17/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Out-of-hospital-cardiac arrest (OHCA) is frequently linked to environmental exposures. Climate change and global warming phenomenon have been found related to cardiovascular morbidity, however there is no agreement on their impact on OHCA occurrence. In this nationwide analysis, we aimed to assess the incidence of the OHCA events attended by emergency medical services (EMS), in relation to meteorological conditions: temperature, humidity, heat index and solar radiation. METHODS We analyzed all adult cases of OHCA in Israel attended by EMS during 2016-2017. In the case-crossover design, we compared ambient exposure within 72 h prior to the OHCA event with exposure prior to the four control times using conditional logistic regression in a lag-distributed non-linear model. RESULTS There were 12,401 OHCA cases (68.3% were pronounced dead-on-scene). The patients were on average 75.5 ± 16.2 years old and 55.8% of them were males. Exposure to 90th and 10th percentile of temperature adjusted to humidity were positively associated with the OHCA with borderline significance (Odds Ratio (OR) =1.20, 95%CI 0.97; 1.49 and OR 1.16, 95%CI 0.95; 1.41, respectively). Relative humidity below the 10th percentile was a risk factor for OHCA, independent of temperature, with borderline significance (OR = 1.16, 95%CI 0.96; 1.38). Analysis stratified by seasons revealed an adverse effect of exposure to 90th percentile of temperature when estimated in summer (OR = 3.34, 95%CI 1.90; 3.5.86) and exposure to temperatures below 10th percentile in winter (OR = 1.75, 95%CI 1.23; 2.49). Low temperatures during a warm season and high temperatures during a cold season had a protective effect on OHCA. The heat index followed a similar pattern, where an adverse effect was demonstrated for extreme levels of exposure. CONCLUSIONS Evolving climate conditions characterized by excessive heat and low humidity represent risk factors for OHCA. As these conditions are easily avoided, by air conditioning and behavioral restrictions, necessary prevention measures are warranted.
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Affiliation(s)
- Hannan Kranc
- Department of Public Health, Faculty of Health Sciences, School of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
- Department of Internal Medicine, Soroka University Medical Center, Beer Sheva, Israel
| | - Alexandra Shtein
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | | | - Lena Novack
- Negev Environmental Health Research Institute, Soroka University Medical Center, 84101 Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Association between shockable rhythm conversion and outcomes in patients with out-of-hospital cardiac arrest and initial non-shockable rhythm, according to the cause of cardiac arrest. Resuscitation 2019; 142:144-152. [DOI: 10.1016/j.resuscitation.2019.07.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/29/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022]
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Seo DE, Shin SD, Song KJ, Ro YS, Hong KJ, Park JH. Effect of hypoxia on mortality and disability in traumatic brain injury according to shock status: A cross-sectional analysis. Am J Emerg Med 2018; 37:1709-1715. [PMID: 30583816 DOI: 10.1016/j.ajem.2018.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES This study aimed to test the association between hypoxia level and outcomes according to shock status in traumatic brain injury (TBI) patients. METHODS Adult TBI patients transported by emergency medical services in 10 provinces were enrolled. Hypoxia was a main exposure; three groups by oxygen saturation (SaO2, non-hypoxia (≥94%), mild hypoxia (90 ≤ SaO2 < 94%)), and severe hypoxia (<90%). Shock status (<systolic blood pressure 90 mmHg) was an interactive exposure. The outcomes were hospital mortality and worsened disability (a 2-point increase of Glasgow Outcome Scale). Multivariable logistic regression was used to calculate the adjusted odds (AORs) with 95% Confidence intervals (CIs). RESULTS Of the 6125 patients, the mortality/disability rates were 49.4%/69.0% in severe hypoxia, 30.7%/46.9% in mild hypoxia, and 18.5%/27.5% in normoxia (p < 0.0001). Mortality/disability rates were 47.1%/57.1% in shock status and 20.5%/31.4% in non-shock status (p < 0.0001). AORs (95% CIs) for worsened disability/mortality compared with normoxia (reference) were 3.23 (2.47-4.21)/2.24 (1.70-2.96) in patients with severe hypoxia and 2.11 (1.63-2.74)/1.84 (1.39-2.45) in those with mild hypoxia. AORs (95% CIs) for worsened disability/mortality was 1.58 (1.20-2.09)/1.33 (1.01-1.76) by severe hypoxia than normoxia in patient with only non-shock status in the interaction analysis. CONCLUSIONS There was a trend toward worsened outcomes with mild and severe hypoxia in patient with and without shock, however, the only met statistical significance for patients with both severe hypoxia and non-shock status.
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Affiliation(s)
- Dong Eun Seo
- Department of Medicine, Seoul National University College of Medicine, Republic of Korea.
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine, Republic of Korea.
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Republic of Korea
| | - Young Sun Ro
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Republic of Korea
| | - Ki Jeong Hong
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Republic of Korea; Department of Emergency Medicine, Seoul National University Hospital, Republic of Korea
| | - Jeong Ho Park
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Republic of Korea
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Kim SH, Shin SD, Song KJ, Ro YS, Kong SY, Kim J, Ko SY, Lee SY. Association between ambient PM 2.5 and emergency department visits for psychiatric emergency diseases. Am J Emerg Med 2018; 37:1649-1656. [PMID: 30522934 PMCID: PMC7126950 DOI: 10.1016/j.ajem.2018.11.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/23/2018] [Accepted: 11/23/2018] [Indexed: 11/07/2022] Open
Abstract
Background Whether or not short-term exposure to particulate matter <2.5 μm in diameter (PM2.5) increases the risk of psychiatric emergency diseases is unclear. Methods The study was performed in a metropolis from January 2015 to December 2016. The exposure was PM2.5, and the confounders were weather (temperature and humidity) and other pollutants (PM10, SO2, CO, O3, and NO2). The outcomes were emergency department (ED) visits with psychiatric disease codes (F00-F99 in ICD10 codes). General additive models were used for the statistical analysis to calculate the adjusted relative risks (ARRs) and 95% confidence intervals (95% CIs) for the daily number of ED visits with a lag of 1 to 3 days following a 10 μg/m3 increase in PM2.5. Results During the study period, a total of 67,561 ED visits for psychiatric diseases were identified and tested for association with PM2.5. Daily ED visits for all psychiatric diseases were not associated with PM2.5 in the model that was not adjusted for other pollutants. The ARR (95% CI) in the model adjusted for SO2 was 1.011 (1.002–1.021) by 10 μg/m3 of PM2.5 on Lag 1 for all psychiatric diseases (F00-F99). The ARR (95% CI) in the model adjusted for O3 was 1.015 (1.003–1.029) by 10 μg/m3 of PM2.5 on Lag 1 for F40-F49 (Neurotic, stress-related and somatoform disorders). Conclusion An increase in PM2.5 showed a significant association with an increase in ED visits for all psychiatric diseases (F00-F99) and for neurotic, stress-related and somatoform disorders (F40-F49) on lag day 1.
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Affiliation(s)
- Sung Hyun Kim
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Sun Ro
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - So Yeon Kong
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Jeongeun Kim
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Seo Young Ko
- Department of Emergency Medicine, Jeju National University Hospital, Jeju, Republic of Korea
| | - Sun Young Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Hensel M, Geppert D, Kersten JF, Stuhr M, Lorenz J, Wirtz S, Kerner T. Association between Weather-Related Factors and Cardiac Arrest of Presumed Cardiac Etiology: A Prospective Observational Study Based on Out-of-Hospital Care Data. PREHOSP EMERG CARE 2018; 22:345-352. [PMID: 29345516 DOI: 10.1080/10903127.2017.1381790] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of this study was to determine the association between weather-related factors and out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology. METHODS This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period. Weather data (temperature, humidity, air pressure, wind speed) were obtained every minute and matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the above-mentioned weather-related factors and OHCA of presumed cardiac etiology. Additionally, varying measuring-ranges were defined for each weather-related factor in order to compare them with each other with regard to the probability of occurrence of OHCA. RESULTS During the observation period 1,558 OHCA with presumed cardiac etiology were registered (age: 67 ± 19 yrs; 62% male; hospital admission: 37%; survival to hospital discharge: 6.7%). Compared to moderate temperatures (5 - 25°C), probability of OHCA-occurrence increased significantly at temperatures above 25°C (p = 0.028) and below 5°C p = 0.011). Regarding air humidity, probability of OHCA-occurrence increased below a threshold-value of 75% compared to values above this cut-off (p = 0.006). Decreased probability was seen at moderate atmospheric pressure (1000 hPa - 1020 hPa), whereas increased probability was seen above 1020 hPa (p = 0.023) and below 1000 hPa (p = 0.035). Probability of OHCA-occurrence increased continuously with increasing wind speed (p < 0.001). CONCLUSIONS There are associations between several weather-related factors such as temperature, humidity, air pressure, and wind speed, and occurrence of OHCA of presumed cardiac etiology. Particularly dangerous seem to be cold weather, dry air and strong wind.
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