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Type: Journal article
Title: Risk factors of direct heat-related hospital admissions during the 2009 heatwave in Adelaide, Australia: a matched case-control study
Author: Zhang, Y.
Nitschke, M.
Krackowizer, A.
Dear, K.
Pisaniello, D.
Weinstein, P.
Tucker, G.
Shakib, S.
Bi, P.
Citation: BMJ Open, 2016; 6(6):e010666-1-e010666-7
Publisher: BMJ PPublishing Group Ltd
Issue Date: 2016
ISSN: 2044-6055
Statement of
Y. Zhang, M. Nitschke, A. Krackowizer, K. Dear, D. Pisaniello, P. Weinstein, G. Tucker, S. Shakib, P. Bi
Abstract: Objective: The extreme heatwave of 2009 in South Australia dramatically increased morbidity, with a 14-fold increase in direct heat-related hospitalisation in metropolitan Adelaide. Our study aimed to identify risk factors for the excess morbidity. Design: A matched case–control study of risk factors was conducted. Setting: Patients and matched community controls were interviewed to gather data on demographics, living environment, social support, health status and behaviour changes during the heatwave. Participants: Cases were all hospital admissions with heat-related diagnoses during the 5-day heatwave in 2009. Controls were randomly selected from communities. Outcome measures: Descriptive analyses, simple and multiple conditional logistic regressions were performed. Adjusted ORs (AORs) were estimated. Results: In total, 143 hospital patients and 143 matched community controls were interviewed, with a mean age of 73 years (SD 21), 96% European ethnicity, 63% retired, 36% with high school or higher education, and 8% institutional living. The regression model indicated that compared with the controls, cases were more likely to have heart disease (AOR=13.56, 95% CI 1.27 to 144.86) and dementia (AOR=26.43, 95% CI 1.99 to 350.73). The protective factors included higher education level (AOR=0.48, 95% CI 0.23 to 0.99), having air-conditioner in the bedroom (AOR=0.12, 95% CI 0.02 to 0.74), having an emergency button (AOR=0.09, 95% CI 0.01 to 0.96), using refreshment (AOR=0.10, 95% CI 0.01 to 0.84), and having more social activities (AOR=0.11, 95% CI 0.02 to 0.57). Conclusions: Pre-existing heart disease and dementia significantly increase the risk of direct heat-related hospitalisations during heatwaves. The presence of an air-conditioner in the bedroom, more social activities, a higher education level, use of emergency buttons and refreshments reduce the risk during heatwaves.
Keywords: Humans; Patient Admission; Morbidity; Logistic Models; Risk Factors; Case-Control Studies; Disasters; Aged; Aged, 80 and over; Middle Aged; Emergency Service, Hospital; South Australia; Female; Male; Extreme Heat; Protective Factors
Rights: Copyright status unknown. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
RMID: 0030048826
DOI: 10.1136/bmjopen-2015-010666
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