Association between heat and upper urinary tract stones morbidity and medical costs: A study in the subtropical humid climate zone

IF 6.4 1区 地球科学 Q1 ENVIRONMENTAL SCIENCES
Chen-Lu Yang , Jun-Zhe Bao , Peng Bi , Ya-Dong Zhang , Chao-Ming Tan , Kai Chen
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引用次数: 0

Abstract

Urolithiasis is a heat-specific disease. Exploring heat-related urolithiasis susceptibility subtypes, economic burden, and modifying factors could assist governments in targeting interventions to reduce the heat-related health risks of urolithiasis morbidity. We collected data on 23,492 patients with upper urinary tract stones (main subtypes of urolithiasis) from 2013 to 2017 in Nanjing, China. We adopted generalized additive quasi-Poisson models to examine the associations between daily mean temperatures and morbidity of upper urinary tract stones, while generalized additive Gaussian models were used to explore the relationships between temperatures and log-transformed medical costs. We examined the modification effects of disease subtypes (kidney and ureteral calculus), sex, and age through stratified analyses and the modification effects of other meteorological factors by introducing interaction terms in the models. We found that short-term summer heat exposure has a statistically significant effect on ureteral calculus morbidity but not on kidney calculus morbidity. For ureter calculus, a 1 °C temperature increase was associated with a 4.36% (95% confidence interval [CI]: 1.94%, 6.83%) increase in daily hospitalization and a 5.44% (95% CI: 2.71%, 8.25%) increase in daily medical costs. The attributable fraction associated with heat (greater than the median value of daily mean temperature, 26.8 °C) was 7.85% (95% empirical confidence interval [eCI]: 3.64%, 11.44%) for hospitalization and 9.36% (95% eCI: 4.91%, 13.14%) for medical costs. The effects of heat on ureter calculus morbidity were significantly higher among the males and those with high sunshine duration than females and those with low sunshine duration. Short-term summer heat exposure was associated with increased morbidity and medical costs of ureteral calculus. Relevant government organizations should take effective intervention measures, including community health education, to reduce the health hazards and economic losses caused by heat.

高温与上尿路结石发病率和医疗费用之间的关系:亚热带湿润气候区的一项研究
泌尿系结石是一种高温特异性疾病。探索与高温相关的泌尿系结石病易感亚型、经济负担和影响因素,有助于政府有针对性地采取干预措施,降低泌尿系结石病发病率与高温相关的健康风险。我们收集了中国南京市2013年至2017年23492名上尿路结石(尿路结石的主要亚型)患者的数据。我们采用广义加法准泊松模型研究了日平均气温与上尿路结石发病率之间的关系,同时采用广义加法高斯模型探讨了气温与对数转换医疗费用之间的关系。我们通过分层分析研究了疾病亚型(肾结石和输尿管结石)、性别和年龄的调节作用,并通过在模型中引入交互项研究了其他气象因素的调节作用。我们发现,夏季短期高温暴露对输尿管结石发病率有显著的统计学影响,但对肾结石发病率没有影响。就输尿管结石而言,温度每升高 1 °C,每天的住院率就会增加 4.36% (95% 置信区间 [CI]:1.94%, 6.83%),每天的医疗费用就会增加 5.44% (95% 置信区间 [CI]:2.71%, 8.25%)。与高温(高于日平均温度中位值 26.8 °C)相关的可归因比例为:住院治疗 7.85%(95% 经验可信区间 [eCI]:3.64%,11.44%),医疗费用 9.36%(95% 经验可信区间 [eCI]:4.91%,13.14%)。高温对输尿管结石发病率的影响在男性和日照时间长的人群中明显高于女性和日照时间短的人群。夏季短期高温暴露与输尿管结石发病率和医疗费用的增加有关。相关政府机构应采取有效的干预措施,包括社区健康教育,以减少高温对健康造成的危害和经济损失。
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来源期刊
Advances in Climate Change Research
Advances in Climate Change Research Earth and Planetary Sciences-Atmospheric Science
CiteScore
9.80
自引率
4.10%
发文量
424
审稿时长
107 days
期刊介绍: Advances in Climate Change Research publishes scientific research and analyses on climate change and the interactions of climate change with society. This journal encompasses basic science and economic, social, and policy research, including studies on mitigation and adaptation to climate change. Advances in Climate Change Research attempts to promote research in climate change and provide an impetus for the application of research achievements in numerous aspects, such as socioeconomic sustainable development, responses to the adaptation and mitigation of climate change, diplomatic negotiations of climate and environment policies, and the protection and exploitation of natural resources.
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