Evidence map›Paper›PMID 42336790›Full record

ArticleBMJ open2026

Extreme heat and cause-specific risk of hospital admission in the adult population in England: a case time series analysis.

Gillian Flower, Rebecca Cole, Arturo De La Cruz Libardi, Luis Mieiro, Jennifer K Quint, Antonio Gasparrini, Pierre Masselot

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

7 authors.

Gillian FlowerEnvironment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK gillian.flower@dhsc.gov.uk.ORCID http://orcid.org/0000-0001-7535-8398
Rebecca ColeEnvironment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
Arturo De La Cruz LibardiEnvironment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
Luis MieiroEnvironment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
Jennifer K QuintSchool of Public Health, Imperial College London Faculty of Medicine, London, UK.ORCID http://orcid.org/0000-0003-0149-4869
Antonio GasparriniEnvironment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-2271-3568
Pierre MasselotEnvironment & Health Modelling (EHM) Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectivesThis study investigated the impact of heat on the risk of hospital admission due to a range of health conditions in England.

designWe used records of over 4 million hospital admissions in the summer months between 2008 and 2019, to construct daily time series of admissions in 32 837 census areas. Coupled with high-resolution environmental data, we conducted a case time-series analysis using distributed-lag non-linear models to measure the lagged relationship between summertime temperature and risk of admission for a broad set of health conditions. We derived the relative risks of admission at the 99th compared with the 50th temperature percentile to understand the effect of extreme heat in each locality.

settingThe adult population of England (aged 18 years and older). OUTCOME MEASURES: Unplanned National Health Service (NHS) in-patient hospital admissions for cardiovascular, respiratory, genitourinary, metabolic and infectious diseases, along with their subcategories.

resultsThese conditions contributed more than 3.7 million admissions, of which over 1.5 million (42%) were for those aged 75 years and over. More than 80% of admissions were for respiratory, cardiovascular or genitourinary illness, which collectively contributed 3.1 million hospital admissions. There was clear evidence of an increased risk of hospital admission for many conditions, including acute renal failure (1.37, 95% CI 1.32 to 1.42), metabolic disorders (1.28, 95% CI 1.24 to 1.32), infectious and parasitic diseases (1.06, 95% CI 1.04 to 1.08), pneumonia (1.07, 95% CI 1.05 to 1.09) and chronic obstructive pulmonary disease (1.08, 95% CI 1.05 to 1.10). The evidence was less clear for asthma and diabetes, while there were negative associations for many cardiovascular conditions. There was a clear age gradient in heat-related admissions, with older people facing the greatest risk of admission.

conclusionsThese findings highlight the widespread effect of extreme heat across a range of health conditions, in addition to mortality, and have implications for public health planning in our changing climate.

Indexed as

Extreme HeatHospitalizationPatient AdmissionAdolescentAdultAgedAged, 80 and overCardiovascular DiseasesEnglandFemaleHumansMaleMiddle AgedRisk FactorsSeasonsYoung AdultClimate ChangeEPIDEMIOLOGYHealthHospitalizationPUBLIC HEALTHRisk Factors

Identifiers

PMID42336790
PMCPMC13295835

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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.