Characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the Midwestern US: A retrospective case-crossover study

Aim: To explore the association between daily extreme heat exposure (daily mean temperature is greater than the 90th percentile for the month) and pediatric (birth to 18 years old) urgent care clinic, emergency department, and inpatient hospitalization discharge diagnoses for any causes and 12 indiv...

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Main Authors: Sarah Oerther, Zachary Phillips, Zidong Zhang, Joanne Salas, Sarah Farabi, Tamara Otey
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844025005092
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author Sarah Oerther
Zachary Phillips
Zidong Zhang
Joanne Salas
Sarah Farabi
Tamara Otey
author_facet Sarah Oerther
Zachary Phillips
Zidong Zhang
Joanne Salas
Sarah Farabi
Tamara Otey
author_sort Sarah Oerther
collection DOAJ
description Aim: To explore the association between daily extreme heat exposure (daily mean temperature is greater than the 90th percentile for the month) and pediatric (birth to 18 years old) urgent care clinic, emergency department, and inpatient hospitalization discharge diagnoses for any causes and 12 individual morbidities of interest. Design: A time-stratified, case-crossover study design. Methods: We analyzed discharge diagnoses from the Saint Louis University-Sisters of St. Mary, a non-profit healthcare system in the United States, using the Virtual Data Warehouse. Our analysis encompassed urgent care clinic visits, emergency department visits, and hospitalizations within a Midwestern healthcare network across Missouri, Wisconsin, the Oklahoma City metropolitan area, and Southern Illinois, in the United States. Our study focused on all causes and examined 12 specific morbidities of interest. We focused on pediatric patients during the warm season months of May through September in 2017–2022. For all outcome models, an overall model was calculated and then each model was stratified by age, sex, race, and neighborhood socioeconomic status, excluding strata with unknown values. Results: We found significant associations with dehydration, general symptoms, heat-related illnesses, and infections. The impact of extreme heat exposure varied across demographics, with vulnerable groups including children aged one to four, males, and individuals from low socioeconomic status areas. Conclusions: Our findings highlight important opportunities for health promotion in communities and preschools. Better informing caregivers of the risks and implementing policy level initiatives may help reduce pediatric exposure to extreme heat. Future research should focus on longitudinal studies to explore these dynamics further and develop effective heat mitigation strategies to protect vulnerable pediatric populations from the adverse effects of extreme heat.
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spelling doaj-art-574eafa6aade4f21b934d427e2cb3a2b2025-01-27T04:22:04ZengElsevierHeliyon2405-84402025-02-01113e42129Characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the Midwestern US: A retrospective case-crossover studySarah Oerther0Zachary Phillips1Zidong Zhang2Joanne Salas3Sarah Farabi4Tamara Otey5Goldfarb School of Nursing, Barnes-Jewish College, St. Louis, MO, 63110, USA; Corresponding author. Goldfarb School of Nursing, Barnes-Jewish College 4483 Duncan Ave., St. Louis, MO, 63110, USA.Geospatial Institute, Saint Louis University School of Medicine, Saint Louis, MO, USAAdvanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, Saint Louis, MO, USAAdvanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, Saint Louis, MO, USAGoldfarb School of Nursing, Barnes-Jewish College, St. Louis, MO, 63110, USAGoldfarb School of Nursing, Barnes-Jewish College, St. Louis, MO, 63110, USAAim: To explore the association between daily extreme heat exposure (daily mean temperature is greater than the 90th percentile for the month) and pediatric (birth to 18 years old) urgent care clinic, emergency department, and inpatient hospitalization discharge diagnoses for any causes and 12 individual morbidities of interest. Design: A time-stratified, case-crossover study design. Methods: We analyzed discharge diagnoses from the Saint Louis University-Sisters of St. Mary, a non-profit healthcare system in the United States, using the Virtual Data Warehouse. Our analysis encompassed urgent care clinic visits, emergency department visits, and hospitalizations within a Midwestern healthcare network across Missouri, Wisconsin, the Oklahoma City metropolitan area, and Southern Illinois, in the United States. Our study focused on all causes and examined 12 specific morbidities of interest. We focused on pediatric patients during the warm season months of May through September in 2017–2022. For all outcome models, an overall model was calculated and then each model was stratified by age, sex, race, and neighborhood socioeconomic status, excluding strata with unknown values. Results: We found significant associations with dehydration, general symptoms, heat-related illnesses, and infections. The impact of extreme heat exposure varied across demographics, with vulnerable groups including children aged one to four, males, and individuals from low socioeconomic status areas. Conclusions: Our findings highlight important opportunities for health promotion in communities and preschools. Better informing caregivers of the risks and implementing policy level initiatives may help reduce pediatric exposure to extreme heat. Future research should focus on longitudinal studies to explore these dynamics further and develop effective heat mitigation strategies to protect vulnerable pediatric populations from the adverse effects of extreme heat.http://www.sciencedirect.com/science/article/pii/S2405844025005092Extreme heatPediatricEmergency
spellingShingle Sarah Oerther
Zachary Phillips
Zidong Zhang
Joanne Salas
Sarah Farabi
Tamara Otey
Characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the Midwestern US: A retrospective case-crossover study
Heliyon
Extreme heat
Pediatric
Emergency
title Characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the Midwestern US: A retrospective case-crossover study
title_full Characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the Midwestern US: A retrospective case-crossover study
title_fullStr Characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the Midwestern US: A retrospective case-crossover study
title_full_unstemmed Characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the Midwestern US: A retrospective case-crossover study
title_short Characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the Midwestern US: A retrospective case-crossover study
title_sort characterizing pediatric discharge diagnoses associated with daily extreme heat exposure in the midwestern us a retrospective case crossover study
topic Extreme heat
Pediatric
Emergency
url http://www.sciencedirect.com/science/article/pii/S2405844025005092
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