Multimorbidity and emergency hospitalisations during hot weather
- PMID: 38705102
- PMCID: PMC11087953
- DOI: 10.1016/j.ebiom.2024.105148
Multimorbidity and emergency hospitalisations during hot weather
Abstract
Background: People with chronic diseases are a commonly listed heat-vulnerable group in heat-health action plans. While prior research identifies multiple health conditions that may increase vulnerability to ambient heat, there is minimal evidence regarding the implications of multimorbidity (two or more chronic diseases).
Methods: From the statewide hospital registry of Queensland, Australia, we identified people aged ≥15 years who had emergency hospitalisation(s) between March 2004 and April 2016 and previously had 0, 1, 2, or ≥3 of five chronic diseases: cardiovascular disease, diabetes, mental disorders, asthma/COPD, and chronic kidney disease. We conducted time-stratified case-crossover analyses to estimate the odds ratio of hospitalisations associated with ambient heat exposure in people with different numbers, types, and combinations of chronic diseases. Ambient heat exposure was defined as a 5 °C increase in daily mean temperature above the median.
Findings: There were 2,263,427 emergency hospitalisations recorded (48.7% in males and 51.3% in females). When the mean temperature increased, hospitalisation odds increased with chronic disease number, particularly in older persons (≥65 years), males, and non-indigenous people. For instance, in older persons with 0, 1, 2, or ≥3 chronic diseases, the odds ratios associated with ambient heat exposure were 1.00 (95% confidence interval: 0.96, 1.04), 1.06 (1.02, 1.09), 1.08 (1.02, 1.14), and 1.13 (1.07, 1.19), respectively. Among the chronic diseases, chronic kidney disease, and asthma/COPD, either existing alone, together, or in combination with other diseases, were associated with the highest odds of hospitalisations under ambient heat exposure.
Interpretation: While individuals with multimorbidity are considered in heat-health action plans, this study suggests the need to consider specifically examining them as a distinct and vulnerable subgroup.
Funding: Wellcome.
Keywords: Chronic disease; Heat-health action plan; Multimorbidity.
Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of interests We declare no competing interests.
Figures
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References
-
- Ebi K.L., Capon A., Berry P., et al. Hot weather and heat extremes: health risks. Lancet. 2021;398(10301):698–708. - PubMed
-
- Jay O., Capon A., Berry P., et al. Reducing the health effects of hot weather and heat extremes: from personal cooling strategies to green cities. Lancet. 2021;398(10301):709–724. - PubMed
-
- Xu Z., FitzGerald G., Guo Y., Jalaludin B., Tong S. Impact of heatwave on mortality under different heatwave definitions: a systematic review and meta-analysis. Environ Int. 2016;89-90:193–203. - PubMed
-
- McGregor G.R., Bessemoulin P., Ebi K., Menne B. World Meteorological Organization and World Health Organization; 2015. Heatwaves and health: guidance on warning-system development.
-
- Matthies F., Bickler G., Cardeñosa Marín N., Hales S. World Health Organization; Regional Office for Europe: 2008. Heat–health action plans: guidance.
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