Tropical cyclone exposure is associated with increased hospitalization rates in older adults.
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ABSTRACT:
SUBMITTER: Parks RM
PROVIDER: S-EPMC7943804 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Tropical cyclones that rapidly intensify are typically associated with the highest forecast errors and cause a disproportionate amount of human and financial losses. Therefore, it is crucial to understand if, and why, there are observed upward trends in tropical cyclone intensification rates. Here, we utilize two observational datasets to calculate 24-hour wind speed changes over the period 1982-2009. We compare the observed trends to natural variability in bias-corrected, high-resolution, global coupled model experiments that accurately simulate the climatological distribution of tropical cyclone intensification. Both observed datasets show significant increases in tropical cyclone intensification rates in the Atlantic basin that are highly unusual compared to model-based estimates of internal climate variations. Our results suggest a detectable increase of Atlantic intensification rates with a positive contribution from anthropogenic forcing and reveal a need for more reliable data before detecting a robust trend at the global scale.
| S-EPMC6367364 | biostudies-literature
Project description:BackgroundAlbuminuria is highly prevalent among older adults, especially those with diabetes. It is associated with several chronic diseases, but its overall impact on the health of older adults, as measured by hospitalization, has not been quantified.MethodWe followed up 3,110 adults, mean age 78 years, for a median 9.75 years, of whom 654 (21%) had albuminuria (≥30 mg albumin/gram creatinine) at baseline. Poisson regression models, adjusted for cardiovascular, renal, and demographic factors, were used to evaluate the association of albuminuria with all-cause and cause-specific hospitalizations, as defined by ICD, version 9, categories.ResultsThe rates of hospitalization per 100 patient-years were 65.85 for participants with albuminuria and 37.55 for participants without albuminuria. After adjustment for covariates, participants with albuminuria were more likely to be hospitalized for any cause than participants without albuminuria (incident rate ratio, 1.39 [95% confidence intervals, 1.27. 1.53]) and to experience more days in hospital (incident rate ratio 1.56 [1.37, 1.76]). The association of albuminuria with hospitalization was similar among participants with and without diabetes (adjusted incident rate ratio for albuminuria versus no albuminuria: diabetes 1.37 [1.11, 1.70], no diabetes 1.40 [1.26, 1.55]; p interaction nonsignificant). Albuminuria was significantly associated with hospitalization for circulatory, endocrine, genitourinary, respiratory, and injury categories.ConclusionsAlbuminuria in older adults is associated with an increased risk of hospitalization for a broad range of illnesses. Albuminuria in the presence or absence of diabetes appears to mark a generalized vulnerability to diseases of aging among older adults.
| S-EPMC7662181 | biostudies-literature
Project description:ObjectiveTo investigate the association between older adults' potentially avoidable hospitalization rates and both a geographic measure of primary care physician (PCP) access and a standard bounded-area measure of PCP access.Data sourcesState physician licensure data from the Virginia Board of Medicine. Patient-level hospital discharge data from Virginia Health Information. Area-level data from the American Community Survey and the Area Health Resources Files. Virginia Information Technologies Agency road network data. US Census Bureau TIGER/Line boundary files.Study designWe use enhanced two-step floating catchment area methods to calculate geographic PCP accessibility for each ZIP Code Tabulation Area in Virginia. We use spatial regression techniques to model potentially avoidable hospitalization rates.Data collection/extractionGeographic accessibility was calculated using ArcGIS. Physician locations were geocoded using TAMU GeoServices and ArcGIS.Principal findingsIncreased geographic access to PCPs is associated with lower rates of potentially avoidable hospitalization among older adults. This association is robust, allowing for spatial spillovers in spatial lag models.ConclusionsCompared to bounded-area density measures, unbounded geographic accessibility measures provide more robust evidence that avoidable hospitalization rates are lower in areas with more PCPs per person. Results from our spatial lag models reveal the presence of positive spatial spillovers.
| S-EPMC6056577 | biostudies-literature
Project description:RATIONALE: Desert dust particles, including quartz, which causes inflammatory responses in the airway in animal studies, are transported to widespread regions around the globe. Epidemiologically, areas impacted by desert dust storms, such as communities in the Middle East and the Caribbean, seem to have higher incidences of asthma than might be expected. OBJECTIVES: We investigated the magnitude of association between airborne mineral dust concentration and hospitalization of children for asthma exacerbation by using Light Detection And Ranging (LIDAR) with a polarization analyzer for an exposure measurement, which can distinguish mineral dust particles from other particles. METHODS: A case-crossover design was used. The exposure measurement was LIDAR's nonspherical extinction coefficient. The outcome measurement was hospitalization of children aged 1 to 15 years for asthma exacerbation in eight principal hospitals in Toyama, a local area in Japan bordering the Japan Sea, during February to April, 2005 to 2009. MEASUREMENTS AND MAIN RESULTS: During the study period, there were 620 admissions for asthma exacerbation, and 6 days with a heavy dust event (daily mineral dust concentration > 0.1 mg/m(3)). Conditional logistic regression showed a statistically significant association between asthma hospitalization and a heavy dust event. The crude odds ratio (OR) of the heavy dust event for hospitalization on the day was 1.88 (95% confidence interval [CI], 1.04-3.41; P = 0.037), and the OR of heavy dust event during the previous week was 1.83 (95% CI, 1.31-2.56; P = 0.00043). The OR adjusted by other air pollutant levels, pollen, and meteorological factors was 1.71 (95% CI, 1.18-2.48; P = 0.0050). CONCLUSIONS: Heavy dust events are associated with an increased risk of hospitalizations for asthma.
| S-EPMC3159090 | biostudies-other
Project description:Background and aimsThe temporal relationship between potentially inappropriate medication (PIM) use and hospitalization remains uncertain. We examined whether current PIM use increases the rate of hospitalization and estimated the rate of hospitalization during exposure to individual PIMs.MethodsA retrospective population-based cohort study of 1?480?137 older adults was conducted using the 2003-2013 Italian Emilia-Romagna Regional administrative healthcare database (~4.5 million residents), which includes demographic, hospital and outpatient prescription information. Each day of follow-up was defined as exposed/unexposed to PIMs that 'should always be avoided', according to the Maio criteria, an Italian modified version of the Beers criteria. The study outcome was all-cause hospitalizations. Crude PIM-related hospitalization rates were calculated for individual PIMs. Repeated-events Cox proportional hazards models with time-dependent covariates estimated adjusted hazard ratios for hospitalization during PIM exposure, as defined by three versions of the Maio criteria (v2007, v2011, v2014).ResultsDuring >10 million person-years of follow-up, 54.2% of individuals used ?1 PIM and 10.9% of all person-time was exposed to v2014 PIMs. Among 1?604?901 hospitalizations, 15.6% occurred during v2014 PIM exposure. Crude hospitalization rates during v2014 PIM-exposed and unexposed person-time were 228.1 and 152.1 per 1000 person-years, respectively. The PIM with the highest rate of hospitalization was ketorolac, while nonsteroidal anti-inflammatory drugs had the most exposure time. The hazard of hospitalization was 16% greater (hazard ratio = 1.16; 95% confidence interval 1.14, 1.18) among patients exposed to v2014 PIMs. The v2007 and v2011 estimates were similar.ConclusionsIn this large population-based cohort of older adults, we found a 16% increased hospitalization risk associated with PIM exposure.
| S-EPMC5651328 | biostudies-literature
Project description:Tropical cyclones are one of the most destructive natural hazards and much of the damage and casualties they cause are flood-related. Accurate characterization and prediction of total water levels during extreme storms is necessary to minimize coastal impacts. While meteotsunamis are known to influence water levels and to produce severe consequences, their impacts during tropical cyclones are underappreciated. This study demonstrates that meteotsunami waves commonly occur during tropical cyclones, and that they can contribute significantly to total water levels. We use an idealized coupled ocean-atmosphere-wave numerical model to analyze tropical cyclone-induced meteotsunami generation and propagation mechanisms. We show that the most extreme meteotsunami events are triggered by inherent features of the structure of tropical cyclones: inner and outer spiral rainbands. While outer distant spiral rainbands produce single-peak meteotsunami waves, inner spiral rainbands trigger longer lasting wave trains on the front side of the tropical cyclones.
| S-EPMC6997351 | biostudies-literature
Project description:BackgroundPneumonia poses a significant burden to the U.S. health-care system. However, there are few data focusing on severe pneumonia, particularly cases of pneumonia associated with specialized care in intensive care units (ICU).MethodsWe used administrative and electronic medical record data from six integrated health care systems to estimate rates of pneumonia hospitalizations with ICU admissions among adults during 2006 through 2010. Pneumonia hospitalization was defined as either a primary discharge diagnosis of pneumonia or a primary discharge diagnosis of sepsis or respiratory failure with a secondary diagnosis of pneumonia in administrative data. ICU admissions were collected from internal electronic medical records from each system. Comorbidities were identified by ICD-9-CM codes coded during the current pneumonia hospitalization, as well as during medical visits that occurred during the year prior to the date of admission.ResultsWe identified 119,537 adult hospitalizations meeting our definition for pneumonia. Approximately 19% of adult pneumonia hospitalizations had an ICU admission. The rate of pneumonia hospitalizations requiring ICU admission during the study period was 76 per 100,000 population/year; rates increased for each age-group with the highest rates among adults aged ?85 years. Having a co-morbidity approximately doubled the risk of ICU admission in all age-groups.ConclusionsOur study indicates a significant burden of pneumonia hospitalizations with an ICU admission among adults in our cohort during 2006 through 2010, especially older age-groups and persons with underlying medical conditions. These findings reinforce current strategies aimed to prevent pneumonia among adults.
| S-EPMC5732529 | biostudies-literature
Project description:Rates of influenza hospitalizations differ by age, but few data are available regarding differences in laboratory-confirmed rates among adults aged ≥65 years. We evaluated age-related differences in influenza-associated hospitalization rates, clinical presentation, and outcomes among 19 760 older adults with laboratory-confirmed influenza at 14 FluSurv-NET sites during the 2011-2012 through 2014-2015 influenza seasons using 10-year age groups. There were large stepwise increases in the population rates of influenza hospitalization with each 10-year increase in age. Rates ranged from 101-417, 209-1264, and 562-2651 per 100 000 persons over 4 influenza seasons in patients aged 65-74 years, 75-84 years, and ≥85 years, respectively. Hospitalization rates among adults aged 75-84 years and ≥85 years were 1.4-3.0 and 2.2-6.4 times greater, respectively, than rates for adults aged 65-74 years. Among patients hospitalized with laboratory-confirmed influenza, there were age-related differences in demographics, medical histories, and symptoms and signs at presentation. Compared to hospitalized patients aged 65-74 years, patients aged ≥85 years had higher odds of pneumonia (aOR, 1.2; 95% CI, 1.0-1.3; P = .01) and in-hospital death or transfer to hospice (aOR, 2.1; 95% CI, 1.7-2.6; P < .01). Age-related differences in the incidence and severity of influenza hospitalizations among adults aged ≥65 years can inform prevention and treatment efforts, and data should be analyzed and reported using additional age strata.
| S-EPMC6602897 | biostudies-literature
Project description:The locally accumulated damage by tropical cyclones (TCs) can intensify substantially when these cyclones move more slowly. While some observational evidence suggests that TC motion might have slowed significantly since the mid-20th century (1), the robustness of the observed trend and its relation to anthropogenic warming have not been firmly established (2-4). Using large-ensemble simulations that directly simulate TC activity, we show that future anthropogenic warming can lead to a robust slowing of TC motion, particularly in the midlatitudes. The slowdown there is related to a poleward shift of the midlatitude westerlies, which has been projected by various climate models. Although the model's simulation of historical TC motion trends suggests that the attribution of the observed trends of TC motion to anthropogenic forcings remains uncertain, our findings suggest that 21st-century anthropogenic warming could decelerate TC motion near populated midlatitude regions in Asia and North America, potentially compounding future TC-related damages.
| S-EPMC7176414 | biostudies-literature
Project description:Theoretical models of the potential intensity of tropical cyclones (TCs) suggest that TC rainfall rates should increase in a warmer environment but limited observational evidence has been studied to test these hypotheses on a global scale. The present study explores the general trends of TC rainfall rates based on a 19-year (1998-2016) time series of continuous observational data collected by the Tropical Rainfall Measuring Mission and the Global Precipitation Measurement mission. Overall, observations exhibit an increasing trend in the average TC rainfall rate of about 1.3% per year, a fact that is contributed mainly by the combined effect of the reduction in the inner-core rainfall rate with the increase in rainfall rate on the rainband region. We found that the increasing trend is more pronounced in the Northwestern Pacific and North Atlantic than in other global basins, and it is relatively uniform for all TC intensities. Further analysis shows that these trends are associated with increases in sea surface temperature and total precipitable water in the TC environment.
| S-EPMC8429722 | biostudies-literature