Abstract 4368792: Extreme Temperatures are Associated with Hospital Admissions Across Central Massachusetts

Abstract

Backround: Extreme weather and temperature can impact human health and influence acute care needs, particularly among older patients. Assessing for better metrics to measure extreme temperature is necessary to better model how extreme temperature affect these acute care needs. Hypothesis: Hospital admissions will be more strongly associated with Extreme hot and cold temperatures and advanced metrics will better capture these associations. Methods: A retrospective cohort was created based on electronic health record data from the predominant safety-net health system in central Massachusetts from April 2021 to April 2024. The primary exposure variables were daily weather indices defined for each patient’s residential address: ambient temperature, wet bulb globe temperature (WBGT), universal thermal climate index (UTCI), and heat index. The primary outcome variable was the daily count of inpatient admissions due to cardiovascular, stroke, renal, and pulmonary disease among adults. Separate generalized additive model with a Poisson distribution were used to estimate the incidence rate ratio of daily hospital admissions in association with different daily temperature indices. Results: We observed 83,469 hospital admissions that met the inclusion criteria during the study period; these were based on data from 44,156 individual patients (mean age 67.9 years; 50.8% male). In comparison with normal temperature indices, we observed a decreased association for hospital admission on extreme cold days as measured by ambient temperature (IRR: 0.66 [95% CI, 0.50-0.87]) and UTCI (IRR: 0.89 [0.83-0.95]) but an increased association for hospital admission on extreme warm days as measured by WBGT (IRR: 1.06 [1.01-1.13]) and UTCI (IRR: 1.06 [1.01-1.12]) (table 1). Through stratified trend analysis, we observed stronger association between weather variables and admissions among older patients (table 2). Conclusions: Hospital admissions across central Massachusetts were associated with extreme heat events but not extreme cold events. Strategies that consider temperature pattern and its effects on acute care needs can be helpful in healthcare planning and hold potential to inform individual-level risk for exacerbation of neuro-cardio-pulmonary-renal conditions.