The impact of diurnal temperature range on the risk of hospitalizations in a low-income setting: the case of the Central Coast of Vietnam.

Abstract

The study aims to evaluate the effects of diurnal temperature range (DTR) on all causes, cardiovascular and respiratory conditions in the Central Coast of Vietnam, a tropical, low-income region with high DTR exposure but limited research. Daily hospital admission data from the largest hospitals in three provinces were analyzed alongside meteorological data. A time-series analysis using a generalized linear distributed lag model was conducted to examine the non-linear DTR-hospitalization association. A random-effect meta-analysis using restricted maximum likelihood was performed to calculate the pooled effects across three provinces. Stratified analyses by gender, age, season and natural disaster occurrence were conducted to identify vulnerable subpopulations. The multi-province pooled effects indicated that a 1 °C increase in DTR raised the risk of hospitalizations for all causes and respiratory diseases by 1.5% [1.2-1.8%] and 0.5% [0.0-1.0%], at lag 0-6 days. The effects of DTR on cardiovascular diseases, as well as those stratified by subgroups, were not statistically significant. Additionally, DTR had a greater adverse effect during the dry season and in the presence of natural disaster. Females and the elderly were slightly more susceptible to respiratory admissions, while males and younger individuals had a higher risk of all-cause admissions due to greater DTR effects. DTR was an independent risk factor for the exacerbation of all and specific causes, particularly among the susceptible subgroups. The findings suggested that it is necessary to take preventive measures to protect these at-risk populations from the adverse effects of extreme DTR exposure.