郭亮, 王烨菁, 贾晓东, 叶辉, 张艳, 倪一宏, 余勇夫. 气温对上海市某中心城区医院急诊内科就诊量的影响[J]. 环境与职业医学, 2017, 34(4): 321-325. DOI: 10.13213/j.cnki.jeom.2017.16431
引用本文: 郭亮, 王烨菁, 贾晓东, 叶辉, 张艳, 倪一宏, 余勇夫. 气温对上海市某中心城区医院急诊内科就诊量的影响[J]. 环境与职业医学, 2017, 34(4): 321-325. DOI: 10.13213/j.cnki.jeom.2017.16431
GUO Liang, WANG Ye-jing, JIA Xiao-dong, YE Hui, ZHANG Yan, NI Yi-hong, YU Yong-fu. Effect of temperature on emergency visits to internal medicine department of a hospital in downtown Shanghai[J]. Journal of Environmental and Occupational Medicine, 2017, 34(4): 321-325. DOI: 10.13213/j.cnki.jeom.2017.16431
Citation: GUO Liang, WANG Ye-jing, JIA Xiao-dong, YE Hui, ZHANG Yan, NI Yi-hong, YU Yong-fu. Effect of temperature on emergency visits to internal medicine department of a hospital in downtown Shanghai[J]. Journal of Environmental and Occupational Medicine, 2017, 34(4): 321-325. DOI: 10.13213/j.cnki.jeom.2017.16431

气温对上海市某中心城区医院急诊内科就诊量的影响

Effect of temperature on emergency visits to internal medicine department of a hospital in downtown Shanghai

  • 摘要: 目的 探索上海市区黄浦区气温与该市中心城区医院急诊内科就诊量的关系。

    方法 收集2009-2014年上海市黄浦区中心医院急诊内科就诊量,每日气温、气湿和气压,及大气污染数据,应用时间序列分析中的准泊松广义相加模型(GAM)分析6年间日均气温与急诊内科就诊量的关系,在模型中引入分布滞后非线性模型(DLNM)建立温湿度的关系式,并在模型中控制与时间有关的混杂因素。

    结果 2009-2014年,气温对于该院急诊内科就诊量变化的暴露反应关系呈J型分布,低温和高温就诊量均增加,低温效应可长达2周以上。就诊量最低的温度(即就诊风险最低的适宜温度)为7℃左右,最低温度相比适宜温度,急诊内科日均就诊量增加至1.09倍(95%CI:1.03~1.16),而最高温度相比适宜温度,日均就诊量增加至1.27倍(95%CI:1.08~1.50)。较适宜温度每下降1℃,就诊量增长2.43%(95%CI:0.83%~4.18%);每上升1℃,就诊量增长0.96%(95%CI:0.31%~1.64%)。

    结论 黄浦区低温和高温均对急诊内科就诊量的增加有明显影响,低温对就诊量增加的效应更持久。

     

    Abstract: Objective To assess the association of temperature and emergency visits to internal medicine department of a downtown hospital in Shanghai.

    Methods Meteorological data including daily temperature, humidity, and air pressure, air pollution data, as well as visits to the emergency internal medicine department in Shanghai Huangpu District Center Hospital were collected from 2009 to 2014. Quasi-Poisson generalized additive model (GAM) for time-series analysis was used to assess the association between daily mean temperature and emergency visits. Distributed lag nonlinear model (DLNM) was built to examine the lag effects of temperature and humidity while other potential time relevant confounders were considered.

    Results A J-shaped relationship was found between daily mean temperature and emergency visits to internal medicine department of the studied hospital, which showed that both cold and hot temperatures increased emergency visits, especially the potential effect of cold temperature lasted more than two weeks. The optimum temperature (OT) corresponding to the lowest risk of emergency visits was about 7℃. The relative risks of cold and hot temperatures versus OT were 1.09 (95%CI: 1.03-1.16) and 1.27 (95%CI: 1.08-1.50), respectively. The overall excess risk of the visits associated with 1℃ below OT was 2.43% (95%CI: 0.83%-4.18%) for cold effect and that associated with 1℃ above OT was 0.96% (95%CI: 0.31%-1.64%) for hot effect.

    Conclusion Both cold and hot temperatures are associated with increased risk of emergency visits to internal medicine department in Huangpu District. The effect lasts longer for cold temperature.

     

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