Evidence map›Paper›PMID 42187888›Full record

ReviewDiseases (Basel, Switzerland)2026

Effects of Heat Waves on Hospitalizations, Emergency Department Visits, and Outpatient Care in Frail Older Adults: A Systematic Review and Meta-Analysis.

Antonio Pinto, Flavia Pennisi, Stefania Borlini, Emanuele De Ponti, Carlo Signorelli, Andrea Cozza, Vincenzo Baldo, Vincenza Gianfredi

Abstract readReview
In one paragraph

Review in Diseases (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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.

Antonio PintoFaculty of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy.ORCID 0009-0006-4315-0481
Flavia PennisiFaculty of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy.ORCID 0009-0001-9185-9747
Stefania BorliniFaculty of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy.
Emanuele De PontiFaculty of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy.ORCID 0009-0000-2312-3693
Carlo SignorelliFaculty of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy.ORCID 0000-0001-9710-4962
Andrea CozzaDepartment of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padova, Italy.ORCID 0000-0001-9156-9312
Vincenzo BaldoDepartment of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padova, Italy.ORCID 0000-0001-6012-9453
Vincenza GianfrediDepartment of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padova, Italy.ORCID 0000-0003-3848-981X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesHeat waves are increasingly frequent and intense climate events with significant implications for public health, particularly among frail older adults. While most evidence has focused on mortality and morbidity, healthcare service utilization represents an additional and potentially more sensitive indicator of heat-related health burden.

methodsA systematic review and meta-analysis was conducted following the PRISMA guidelines and prospectively registered in PROSPERO (CRD420251107598). PubMed/MEDLINE, Scopus, and Web of Science were searched up to August 2025. This study aimed to systematically review and quantitatively synthesize the evidence on the association between heat wave exposure and healthcare utilization-including hospitalizations, emergency department (ED) visits, and outpatient care-among frail older adults. Pooled effect estimates (RRs, IRRs, and ORs) were calculated using random-effects models. Heterogeneity was assessed using the I

resultsFifty-five studies met the inclusion criteria. Heat wave exposure was consistently associated with increased healthcare utilization. Both hospitalizations and ED visits showed significant increases during heat wave periods, with results remaining robust across sensitivity analyses. Evidence on outpatient care was limited but suggested a similar pattern. Substantial heterogeneity was observed across studies, reflecting variability in exposure definitions, populations, and study designs. Overall, the methodological quality of the included studies was acceptable, with most presenting a low-to-moderate risk of bias.

conclusionsHeat waves are associated with increased healthcare utilization among frail older adults, indicating a relevant burden on healthcare systems. Healthcare utilization may represent a sensitive indicator of heat wave impact, complementing traditional clinical outcomes.

Indexed as

climate changeemergency department visitsfrailtyhealthcare utilizationheat waveshospitalizationsolder adultsoutpatient carepublic health

Identifiers

PMID42187888
PMCPMC13205340

What OpenQuestion holds

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Registered trials

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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.