Yu-Chun Wang1,2, Yi-Chun Chen3, Chun-Yu Ko1, Yue-Liang Leon Guo4,5, Fung-Chang Sung6,7. 1. Department of Environmental Engineering, College of Engineering, Zhongli, Taiwan. 2. Research Center for Environmental Risk Management, Chung Yuan Christian University, Zhongli, Taiwan. 3. Department of Health Management, I-Shou University, Kaohsiung, Taiwan. 4. Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. 5. Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan. 6. Department of Health Services Administration, China Medical University, Taichung, Taiwan. 7. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Abstract
BACKGROUND: This study evaluated risks of emergency room visit (ERV) for out-of-hospital cardiac arrest (OHCA) in 2005-2011, among patients with cardiologic and metabolic syndromes (CMS), in association with ambient environments. METHODS: Pooled and area-specific weather related cumulative six-day (lags 0 to 5) relative risks (RRs) and confidence intervals (CIs) of ERV for OHCA were evaluated for CMS cases, using distributed lag nonlinear models and multivariate meta-analytical second-stage model in association with the daily average temperatures and daily concentrations of air pollutants. RESULTS: ERV risk increased as average temperature dropped to <27°C. At the mean temperature of 14°C, the cumulative six-day RRs of ERV were 1.73 (95% CI: 1.22, 2.46) for all OHCA patients, 1.74 (95% CI: 1.06, 2.84) for OHCA patients younger than 65 years old, and 1.99 (95% CI: 1.03, 3.81) for subjects with pre-existing hypertension. High temperature was also associated with elevated ERV of OHCA. Increased ERV risks in cases with pre-existing hypertension and diabetes mellitus were also associated with concentrations of air pollutants in northern Taiwan. CONCLUSIONS: Our data provided evidences to clinicians, emerging medical services and public health that the ERV risk for OHCA patients is greater at low temperature than at high temperature. Patients with cardio and metabolic disorders need to pay greater attention to low temperature and avoid heat wave.
BACKGROUND: This study evaluated risks of emergency room visit (ERV) for out-of-hospital cardiac arrest (OHCA) in 2005-2011, among patients with cardiologic and metabolic syndromes (CMS), in association with ambient environments. METHODS: Pooled and area-specific weather related cumulative six-day (lags 0 to 5) relative risks (RRs) and confidence intervals (CIs) of ERV for OHCA were evaluated for CMS cases, using distributed lag nonlinear models and multivariate meta-analytical second-stage model in association with the daily average temperatures and daily concentrations of air pollutants. RESULTS: ERV risk increased as average temperature dropped to <27°C. At the mean temperature of 14°C, the cumulative six-day RRs of ERV were 1.73 (95% CI: 1.22, 2.46) for all OHCA patients, 1.74 (95% CI: 1.06, 2.84) for OHCA patients younger than 65 years old, and 1.99 (95% CI: 1.03, 3.81) for subjects with pre-existing hypertension. High temperature was also associated with elevated ERV of OHCA. Increased ERV risks in cases with pre-existing hypertension and diabetes mellitus were also associated with concentrations of air pollutants in northern Taiwan. CONCLUSIONS: Our data provided evidences to clinicians, emerging medical services and public health that the ERV risk for OHCA patients is greater at low temperature than at high temperature. Patients with cardio and metabolic disorders need to pay greater attention to low temperature and avoid heat wave.
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