title: Temperature changes, temperature extremes, and their relationship to emergency department visits and hospitalizations for sickle cell crisis.
abstract: Weather changes are among the proposed precursors of painful sickle cell crises. However, epidemiologic data are mixed regarding the relationship between ambient temperature and crisis frequency. To study this relationship among a local sickle cell disease population, emergency department (ED) visits and admissions were evaluated in adults with sickle cell crisis as the primary diagnosis at a major teaching hospital in a temperate climate. Official daily ambient temperatures (average for that day) were obtained from the National Climate Data Center for the days patients visited the ED or were hospitalized, and for 24 or 48 hours prior. Daily ED visit counts and admission counts were correlated with the visit/admission day's ambient temperature, with the ambient temperature 24 hours before admission, and with the magnitude of change in daily ambient temperature over the prior 24 or 48 hours. For all correlations, statistical significance was defined as a p value of <0.01 and clinical significance was defined as a moderate or greater correlation, absolute value of r >/= 0.30. ED visits or admissions correlated statistically, but not clinically, with daily temperatures. On days when temperatures were <32 degrees F or >80 degrees F, these correlations were statistically significant, but clinical significance was variable. ED visits or admissions correlated only statistically with temperatures 24 hours prior, even on days when temperatures were <32 degrees F. When temperatures were >80 degrees F, the correlations were statistically significant, but there was a reverse, clinically significant correlation between admissions and temperatures. Finally, only statistically significant correlations were found between ED visits or admissions and change in temperature over the prior 24 or 48 hours. Weak or inconsistent confirmation of a relationship was found between daily ambient temperatures and ED visits or hospital admissions for sickle cell crises.
authors.affiliation: Division of Quality Health Care, Virginia Commonwealth University, 1200 E. Broad St, Rm 10-402, , Richmond, VA 23298-0306, USA. wrsmith@hsc.vcu.edu
authors.forename: Wally R
authors.initials: WR
authors.lastname: Smith
authors.forename: Patrick
authors.initials: P
authors.lastname: Coyne
authors.forename: Virginia S
authors.initials: VS
authors.lastname: Smith
authors.forename: Bruce
authors.initials: B
authors.lastname: Mercier
mesh_terms: D000046:Academic Medical Centers; D000208:Acute Disease; D000328:Adult; D000755:Anemia, Sickle Cell / Q000453:epidemiology* / Q000209:etiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008685:Meteorological Concepts; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D013696:Temperature; D013997:Time Factors; D014768:Virginia / Q000453:epidemiology; D014887:Weather