2019-2021年南京市寒潮、热浪对人群非意外住院风险影响研究

Effects of cold and heat waves on the risk of non-accidental hospital admissions in Nanjing,China,2019-2021

目的分析2019—2021南京市寒潮、热浪对人群非意外住院风险的影响。方法收集2019年1月1日—2021年12月31日南京市4家三级医院(2家三级甲等和2家三级综合医院)每日非意外住院人数及相对应的气象和空气污染资料,采用分布滞后非线性模型(distributed lag non-linear model,DLNM)分析寒潮、热浪对居民非意外住院风险(性别、年龄、住院疾病分组)的影响。结果本研究共收集寒季非意外住院资料137369人次,暖季141313人次。发现寒潮对非意外住院人次(性别、年龄、心血管系统疾病、呼吸系统疾病及肺炎分组)增加的风险均具有统计学意义,但性别分组、年龄分组、疾病分组组中的差异均无统计学意义;热浪仅对非意外住院中的女性人群及短暂性大脑缺血性发作和相关综合征住院人群增加的风险具有统计学意义,RR(95%CI)分别为1.207(1.043,1.396)和1.473(1.023,2.120)。寒潮对人群非意外住院的滞后风险在第0天最高,累积滞后风险在0—21天中均呈上升趋势且具有统计学意义,热浪造成的滞后及累积滞后效应无明显趋势,且多无统计学意义。结论2019—2021年南京市寒潮对人群非意外住院风险造成的影响较热浪更为显著,且存在一定的滞后和累积滞后效应,建议在寒潮期间及之后加强对人群健康的关注。

Objective To analyze the effects of cold and heat waves on the risk of non-accidental hospital admissions in Nanjing,China,from 2019 to 2021.Methods The daily number of non-accidental hospital admissions in four tertiary hospitals(2 grade IIIA hospitals,and 2 grade III comprehensive hospitals)in Nanjing and the corresponding meteorological and air pollution data were collected from January 1,2019 to December 31,2021.The distributed lag non-linear model(DLNM)was performed to analyze the effects of cold and heat waves on the risk of non-accidental hospital admissions(including gender,age,and disease groups)of residents.Results A total of 137369 non-accidental admissions were collected in the cold season and 141313 in the warm season.It was found that an increased risk of non-accidental hospital admissions(in gender,age,cardiovascular disease,respiratory disease,and pneumonia groups)was significantly associated with cold waves,however,the differences in gender,age,and disease groups were not statistically significant.The association between heat waves and increased risk of non-accidental hospital admissions was significant only in female(relative risk(RR)=1.207,95%CI:1.043,1.396)and hospital admissions due to transient ischemic attacks and related syndromes(RR=1.473,95%CI:1.023,2.120).The lag risk of non-accidental hospital admissions due to cold waves was the highest on day 0,and the cumulative lag risk showed an upward trend with statistical significance on days 0 to 21.The lag risk and cumulative lag effects caused by heat waves showed no obvious trend,and most of them were not significant.Conclusion Cold waves in Nanjing from 2019 to 2021 have a more significant effect on the risk of non-accidental hospital admissions than heat waves,which are accompanied by some lag risks and cumulative lag effects.It is suggested to pay more attention to population health during and after cold waves.