Evidence map›Paper›PMID 30921372›Full record

Trial reportPloS one2019

The use of an 'acclimatisation' heatwave measure to compare temperature-related demand for emergency services in Australia, Botswana, Netherlands, Pakistan, and USA.

Naomi van der Linden, Thomas Longden, John R Richards, Munawar Khursheed, Wilhelmina M T Goddijn, Michiel J van Veelen, Uzma Rahim Khan, M Christien van der Linden

Abstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Increasing global temperatures threaten gains in maternal and newborn health in Africa: A review of impacts and an adaptation framework.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023
    Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Naomi van der LindenCentre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia.ORCID 0000-0003-1646-9834
Thomas LongdenCentre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia.
John R RichardsEmergency Department, UC Davis Medical Center, Sacramento, California, United States of America.ORCID 0000-0003-1251-3877
Munawar KhursheedEmergency Department, Aga Khan University Hospital, Karachi, Pakistan.
Wilhelmina M T GoddijnEmergency Department, Academic Medical Centre, Amsterdam, Netherlands.
Michiel J van VeelenPrincess Marina Hospital & Department of Emergency Medicine, University of Botswana, Faculty of Medicine, Gaborone, Botswana.
Uzma Rahim KhanEmergency Department, Aga Khan University Hospital, Karachi, Pakistan.
M Christien van der LindenEmergency Department, Haaglanden Medical Centre, The Hague, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeatwaves have been linked to increased risk of mortality and morbidity and are projected to increase in frequency and intensity due to climate change. The current study uses emergency department (ED) data from Australia, Botswana, Netherlands, Pakistan, and the United States of America to evaluate the impact of heatwaves on ED attendances, admissions and mortality.

methodsRoutinely collected time series data were obtained from 18 hospitals. Two separate thresholds (≥4 and ≥7) of the acclimatisation excess heat index (EHIaccl) were used to define "hot days". Analyses included descriptive statistics, independent samples T-tests to determine differences in case mix between hot days and other days, and threshold regression to determine which temperature thresholds correspond to large increases in ED attendances.

findingsIn all regions, increases in temperature that did not coincide with time to acclimatise resulted in increases in ED attendances, and the EHIaccl performed in a similar manner. During hot days in California and The Netherlands, significantly more children ended up in the ED, while in Pakistan more elderly people attended. Hot days were associated with more patient admissions in the ages 5-11 in California, 65-74 in Karachi, and 75-84 in The Hague. During hot days in The Hague, patients with psychiatric symptoms were more likely to die. The current study did not identify a threshold temperature associated with particularly large increases in ED demand.

interpretationThe association between heat and ED demand differs between regions. A limitation of the current study is that it does not consider delayed effects or influences of other environmental factors. Given the association between heat and ED use, hospitals and governmental authorities should recognise the demands that heat can place on local health care systems. These demands differ substantially between regions, with Pakistan being the most heavily affected within our study sample.

Indexed as

Climate ChangeEmergency Medical ServicesEmergency Service, HospitalAcclimatizationAdolescentAgedAged, 80 and overAustraliaBotswanaCaliforniaChildChild, PreschoolExtreme HeatFemaleHeat Stress DisordersHumans

Identifiers

PMID30921372
PMCPMC6438466

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.