Association between heat and upper urinary tract stones morbidity and medical costs:A study in the subtropical humid climate zone

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外文摘要：Urolithiasis is a heat-specific disease.Exploring heat-related urolithiasis susceptibility subtypes,economic burden,and modifying factors could assist governments in targeting interventions to reduce the heat-related health risks of urolithiasis morbidity.We collected data on 23,492 patients with upper urinary tract stones(main subtypes of urolithiasis)from 2013 to 2017 in Nanjing,China.We adopted generalized additive quasi-Poisson models to examine the associations between daily mean temperatures and morbidity of upper urinary tract stones,while generalized additive Gaussian models were used to explore the relationships between temperatures and log-transformed medical costs.We examined the modification effects of disease subtypes(kidney and ureteral calculus),sex,and age through stratified analyses and the modifi-cation effects of other meteorological factors by introducing interaction terms in the models.We found that short-term summer heat exposure has a statistically significant effect on ureteral calculus morbidity but not on kidney calculus morbidity.For ureter calculus,a 1 ℃ temperature increase was associated with a 4.36％(95％confidence interval[CI]:1.94％,6.83％)increase in daily hospitalization and a 5.44％(95％CI:2.71％,8.25％)increase in daily medical costs.The attributable fraction associated with heat(greater than the median value of daily mean temperature,26.8 ℃)was 7.85％(95％empirical confidence interval[eCI]:3.64％,11.44％)for hospitalization and 9.36％(95％eCI:4.91％,13.14％)for medical costs.The effects of heat on ureter calculus morbidity were significantly higher among the males and those with high sunshine duration than females and those with low sunshine duration.Short-term summer heat exposure was associated with increased morbidity and medical costs of ureteral calculus.Relevant government organizations should take effective intervention measures,including community health education,to reduce the health hazards and economic losses caused by heat.

外文关键词：

HeatUpper urinary tract stonesEconomic burdenModification effects

作者：

Chen-Lu YANG、Jun-Zhe BAO、Peng BI、Ya-Dong ZHANG、Chao-Ming TAN、Kai CHEN

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作者单位：

College of Public Health,Zhengzhou University,Zhengzhou 450001,China

School of Public Health,The University of Adelaide,Adelaide 5000,Australia

Department of Andrology The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China

Nanjing Social Insurance Management Center,Nanjing 210008,China

Department of Environmental Health Sciences,Yale University New Haven 06520,USA

Yale Center on Climate Change and Health,Yale University New Haven 06520,USA

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出版年：

2024

DOI：

10.1016/j.accre.2024.07.001

气候变化研究进展(英文版)

国家气候中心

气候变化研究进展(英文版)

影响因子：0.806

ISSN：1674-9278

年,卷(期)：2024.15(4)