title: Seasonal congestive heart failure mortality and hospitalisation trends, Quebec 1990-1998.
abstract: OBJECTIVE
  To describe seasonal congestive heart failure (CHF) mortality and hospitalisations in Quebec, Canada between 1990-1998 and compare trends in CHF mortality and morbidity with those in France.
  
  
  METHODS
  Population cohort study.
  
  
  METHODS
  Province of Quebec, Canada.
  
  
  METHODS
  Mortality data were obtained from the Quebec Death Certificate Registry and hospitalisation from the Quebec Med-Echo hospital discharge database. Cases with primary ICD-9 code 428 were considered cases of CHF.
  
  
  RESULTS
  Monthly CHF mortality was higher in January, declined until September and then rose steadily (p<0.05). Hospital admissions for CHF declined from May until September (moving averages analysis p<0.0001). Seasonal mortality patterns observed in Quebec were similar to those observed in France.
  
  
  CONCLUSIONS
  CHF mortality in Quebec is highest during the winter and declines in the summer, similar to observations in France and Scotland. This suggests that absolute temperatures may not necessarily be that important but increased CHF mortality is observed once environmental temperatures fall below a certain "threshold" temperature. Alternatively better internal heating and warmer clothing required for survival in Quebec may ameliorate mortality patterns despite colder external environments.
authors.affiliation: Direction de la Santé Publique de Montréal Centre, and Université de Montréal, GRIS et Ecole de réadaption, Quebec, Canada. debbie.feldman@umontreal.ca
authors.forename: D Ehrmann
authors.initials: DE
authors.lastname: Feldman
authors.forename: R
authors.initials: R
authors.lastname: Platt
authors.forename: V
authors.initials: V
authors.lastname: Déry
authors.forename: C
authors.initials: C
authors.lastname: Kapetanakis
authors.forename: D
authors.initials: D
authors.lastname: Lamontagne
authors.forename: A
authors.initials: A
authors.lastname: Ducharme
authors.forename: N
authors.initials: N
authors.lastname: Giannetti
authors.forename: M
authors.initials: M
authors.lastname: Frenette
authors.forename: E J
authors.initials: EJ
authors.lastname: Beck
mesh_terms: D002980:Climate; D003020:Clothing; D015331:Cohort Studies; D003080:Cold Temperature; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control; D006361:Heating / Q000379:methods; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D009026:Mortality / Q000639:trends; D011792:Quebec / Q000453:epidemiology; D012621:Seasons