Ambient temperature and seasonal variation in inpatient mortality from respiratory diseases: a retrospective observational study

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  • dc.contributor.author Achebak, Hicham
  • dc.contributor.author García Aymerich, Judith
  • dc.contributor.author Rey, Grégoire
  • dc.contributor.author Chen, Zhaoyue
  • dc.contributor.author Méndez Turrubiates, Raúl Fernando
  • dc.contributor.author Ballester, Joan
  • dc.date.accessioned 2024-03-27T18:16:15Z
  • dc.date.available 2024-03-27T18:16:15Z
  • dc.date.issued 2023
  • dc.description.abstract Background: The seasonal fluctuation in mortality and hospital admissions from respiratory diseases, with a winter peak and a summer trough, is widely recognized in extratropical countries. However, little is known about the seasonality of inpatient mortality and the role of ambient temperature remains uncertain. We aimed to analyse the association between ambient temperature and in-hospital mortality from respiratory diseases in the provinces of Madrid and Barcelona, Spain. Methods: We used data on daily hospitalisations, weather (ie, temperature and relative humidity) and air pollutants (ie, PM2.5, PM10, NO2 and O3) for the Spanish provinces of Madrid and Barcelona during 2006-2019. We applied a daily time-series quasi-Poisson regression in combination with distributed lag non-linear models (DLNM) to assess, on the one hand, the seasonal variation in fatal hospitalisations and the contribution of ambient temperature, and on the other hand, the day-to-day association between temperature and fatal hospital admissions. The analyses were stratified by sex, age and primary diagnostic of hospitalisation. Findings: The study analysed 1 710 012 emergency hospital admissions for respiratory diseases (mean [SD] age, 60.4 [31.0] years; 44.2% women), from which 103 845 resulted in in-hospital death (81.4 [12.3] years; 45.1%). We found a strong seasonal fluctuation in in-hospital mortality from respiratory diseases. While hospital admissions were higher during the cold season, the maximum incidence of inpatient mortality was during the summer and was strongly related to high temperatures. When analysing the day-to-day association between temperature and in-hospital mortality, we only found an effect for high temperatures. The relative risk (RR) of fatal hospitalisation at the 99th percentile of the distribution of daily temperatures vs the minimum mortality temperature (MMT) was 1.395 (95% eCI: 1.211-1.606) in Madrid and 1.612 (1.379-1.885) in Barcelona. In terms of attributable burden, summer temperatures (June-September) were responsible for 16.2% (8.8-23.3) and 22.3% (15.4-29.2) of overall fatal hospitalisations from respiratory diseases in Madrid and Barcelona, respectively. Women were more vulnerable to heat than men, whereas the results by diagnostic of admission showed heat effects for acute bronchitis and bronchiolitis, pneumonia and respiratory failure. Interpretation: Unless effective adaptation measures are taken in hospital facilities, climate warming could exacerbate the burden of inpatient mortality from respiratory diseases during the warm season. Funding: European Research Council Consolidator Grant EARLY-ADAPT, European Research Council Proof-of-Concept Grants HHS-EWS and FORECAST-AIR.
  • dc.description.sponsorship HA gratefully acknowledges funding from the European Union’s Horizon Europe research and innovation programme under grant agreement No 101065876 (MSCA Postdoctoral Fellowship TEMP-MOMO). HA, ZC, RFMT, and JB acknowledge funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 865564 (European Research Council Consolidator Grant EARLY-ADAPT, https://www.early-adapt.eu/). JB acknowledges funding from the European Union’s Horizon Europe Research and Innovation Programme under grant agreements No 101069213 (European Research Council Proof-of-Concept HHS-EWS) and 101123382 (European Research Council Proof-of-Concept FORECAST-AIR), and from the Spanish Ministry of Science and Innovation under grant agreement No RYC2018-025446-I (programme Ramón y Cajal). ISGlobal authors acknowledge support from the grant CEX2018-000806-S funded by MCIN/AEI/10.13039/501100011033, and support from the Generalitat de Catalunya through the CERCA Program. We acknowledge the E-OBS dataset from the EU-FP6 project UERRA (http://www.uerra.eu) and the Copernicus Climate Change Service, and the data providers in the ECA&D project (https://www.ecad.eu).
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Achebak H, Garcia-Aymerich J, Rey G, Chen Z, Méndez-Turrubiates RF, Ballester J. Ambient temperature and seasonal variation in inpatient mortality from respiratory diseases: a retrospective observational study. Lancet Reg Health Eur. 2023 Nov 7;35:100757. DOI: 10.1016/j.lanepe.2023.100757
  • dc.identifier.doi http://dx.doi.org/10.1016/j.lanepe.2023.100757
  • dc.identifier.issn 2666-7762
  • dc.identifier.uri http://hdl.handle.net/10230/59602
  • dc.language.iso eng
  • dc.publisher Elsevier
  • dc.relation.ispartof Lancet Reg Health Eur. 2023 Nov 7;35:100757
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101065876
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/865564
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101069213
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101123382
  • dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RYC2018-025446-I
  • dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/CEX2018-000806-S
  • dc.rights © 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
  • dc.subject.keyword Heat
  • dc.subject.keyword Hospital mortality
  • dc.subject.keyword Respiratory diseases
  • dc.title Ambient temperature and seasonal variation in inpatient mortality from respiratory diseases: a retrospective observational study
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

Col·leccions

Articles (Departament de Medicina i Ciències de la Vida)
Articles (Barcelona Institute for Global Health (ISGlobal) – Campus Mar)
Documents OpenAIRE (Open Access Infrastructure for Research in Europe)