Too Cold in Winter or Too Hot in Summer: It Is Never a Good Season for Heart Failure Patients

Medical Physiology, School of Health Sciences, National University of the Center of the Buenos Aires Province, Tandil, Argentina.
Cardiology (Impact Factor: 2.18). 02/2011; 117(4):278-9. DOI: 10.1159/000324061
Source: PubMed


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Available from: Alejandro Diaz, Oct 04, 2015
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    ABSTRACT: Previous studies revealed fewer visits for congestive heart failure (CHF) to emergency departments (EDs) in New Jersey, USA and fewer admissions for CHF to a Southern Indian and an Israeli hospital during warmer months. Using hospital admission rate for CHF as a marker for illness severity, we hypothesized that CHF would also be less severe in warmer months. This is a retrospective cohort study which included all ED visits from 1 January 2004 to 31 January 2006. We analysed the monthly CHF hospital admission rates. We a priori chose to compare the admission rates for the 4 warmest to the 4 coldest months. Of a total of 136,347 ED visits, 1083 (0.8%) were accounted for CHF. Hospital admission rate was 55.8%. Although there was a statistically significant increase in ED visits for CHF during the colder months, the 4 warmer months from June to September had 1.15 times higher hospital admission rate than the 4 coldest months from November to February. Contrary to our hypothesis, we found a statistically significant increase in the percentage of CHF visits admitted to the hospital during the warmer months. This suggests that although there are less ED CHF visits in the warmer months, a greater percentage tend to be severe.
    Annals of the Academy of Medicine, Singapore 12/2009; 38(12):1081-4. DOI:10.1016/j.annemergmed.2007.06.218 · 1.15 Impact Factor
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    ABSTRACT: Objective: To determine whether there are patterns in the incidence of emergency department (ED) visits for congestive heart failure (CHF) by month of the year, day of the week, or hour of the day. Methods: This was a retrospective analysis of a computerized billing database of ED visits, involving seven northern New Jersey hospitals EDs. Consecutive patients seen by emergency physicians over an 11-year period (January 1, 1988-December 31, 1998) were included. Chi-square tests were used to evaluate for significant differences (p < 0.05). Results: There were a total of 2,370,233 patients in the database, of whom 26,224 had a primary ED diagnosis of CHF. The chi-square test rejected uniformity for month of the year, for day of the week, and for hour of the day (p < 0.0001). Visits for CHF were increased in the winter months. Compared with the average of the other months, December was the highest (14.3% above, p < 0.0001) and August was the lowest (15.5% below, p < 0.0001). There was also a day-of-the-week variation. Compared with the average of the other days, Monday was the highest (14.5% above, p < 0.0001) and Saturday was the lowest (9.6% below, p < 0.0001). There was also an hour-of-the-day pattern, with a rapid rise after 8 AM and a downtrend after 3 PM. Conclusions: These data revealed a higher incidence of ED visits for CHF in the winter months, on Mondays, and during the hours of 8 AM to 3 PM. In comparison with previous studies, these data revealed a similar pattern by month of the year and a different pattern by hour of the day.
    Academic Emergency Medicine 05/2001; 8(6):682 - 685. DOI:10.1111/j.1553-2712.2001.tb00183.x · 2.01 Impact Factor
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    ABSTRACT: This study was done to determine whether seasonal variation exists in hospitalizations and deaths due to heart failure (HF) and to examine possible contributors to such variability. Although seasonal variation in the incidence of acute myocardial infarction and sudden death is well recognized, it is less well documented in HF. We used the linked Scottish Morbidity Record scheme, which provides individualized morbidity and mortality data for the entire Scottish population. Between 1990 and 1996, there were a total of 75,452 male and 81,269 female hospitalizations related to HF in Scotland, with an average rate of admissions per 100,000 population of 8.4 and 8.5 per day, respectively. Significantly more admissions occurred in winter compared to summer (p < 0.0001). In women, the peak rate of admission occurred in December (12% more than average) and the lowest rate in July (7% less than average) (odds ratio [OR] 1.14, p < 0.001). The respective figures for men were 6% more, 8% less (OR 1.16, p < 0.001). In both genders, the greatest variation occurred in those aged >75 years---peak winter rates being 15% to 18% higher than average. There was also a winter peak in concomitantly coded respiratory disease; this seasonal excess accounted for approximately one-fifth of the winter increment in HF hospitalizations. Seasonal variation in mortality was also seen in these patients. The number of male deaths in December was 16% higher, and in July 7% lower, than average (OR 1.25, p < 0.001). In women, the equivalent figures were 21% higher (January) and 14% lower (July) (OR 1.21, p < 0.001). Again, the greatest variation occurred in those aged >75 years---peak rates being 23% to 35% higher than average. There is substantial seasonal variation in HF hospitalizations and deaths, particularly in the elderly. Approximately one-fifth of the winter excess in admissions is attributable to respiratory disease. Extra vigilance in patients with HF is advisable in winter, as is immunization against pneumococcus and influenza.
    Journal of the American College of Cardiology 04/2002; 39(5):760-6. DOI:10.1016/S0735-1097(02)01685-6 · 16.50 Impact Factor
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