Citation

Claessens YE, Taupin P, Kierzek G, Pourriat JL, Baud M, Ginsburg C, Jais JP, Jougla E, Riou B, Dhainaut JF, Landais P. Crit. Care 2006; 10(6): R156.

Copyright

(Copyright © 2006, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/cc5092

PMID

17096836

PMCID

PMC1794460

Abstract

INTRODUCTION: A major issue raised by the public health consequences of a heat wave is the difficulty in detecting its direct consequences on patient outcome, particularly because of the delay in obtaining definitive mortality results. Since emergency department (ED) activity reflected the global increase of patients health problems during this period, the profile of patients referred to EDs might be a basis to detect an excess mortality in the catchments area. Our objective was to develop a real time surveillance model based on EDs data in order to detect as early as possible excessive heat related mortality. METHODS: A day-to-day composite indicator was built using simple and easily obtainable variables related to the patients referred to the EDs during the 2003 heat wave period. The design was a derivation and validation study based on a real time surveillance system of two EDs at Cochin and Hotel-Dieu hospitals, Paris, France. The participants were 99,976 adult patients registered from May 1st to September 30th over the years 2001, 2002 and 2003. Among these, 3297, 3580, and 3851 were referred to the EDs from August 3rd to 19th for 2001, 2002 and 2003, respectively. Variables retained for the indicator were selected using ROC curves methodology and polynomial regression. RESULTS: The indicator was composed of only three variables: percentage of patients older than 70 years; percentage of patients with body temperature > 39 degrees centigrade and percentage of patients admitted or died in the ED. The curve of the indicator along with time appropriately fitted with the overall mortality that occurred in the region of interest. CONCLUSION: A composite and simple index based on real-time surveillance was developed according to the profile of patients who visited an ED. It appeared suitable for alerting on the overall mortality in the corresponding region submitted to the 2003 heat wave. This index should help alerting early on an excessive mortality and monitoring the efficacy of public health interventions.

Language: en