Increase in out-of-hospital cardiac arrest attended by the medical mobile intensive care units, but not myocardial infarction, during the 2003 heat wave in Paris, France.
OBJECTIVE
To address the association between the 2003 heat wave in Paris (France) and the occurrence of out-of-hospital cardiac arrest.


METHODS
: An analysis of the interventions of the medical mobile intensive care units of the City of Paris for out-of-hospital cardiac arrest and prehospital myocardial infarctions, which were routinely and prospectively computerized from January 1, 2000, to December 31, 2005.


METHODS
City of Paris, France.


METHODS
Participants were consecutive victims of witnessed out-of-hospital cardiac arrest due to heart disease and of ST-segment elevation myocardial infarction (STEMI) aged >or=18 yrs, who were attended by the medical mobile intensive care units (MICUs) of the City of Paris from January 1, 2000, to December 31, 2005.


METHODS
None.


RESULTS
The numbers of out-of-hospital cardiac arrests and of STEMIs during the 2003 heat wave period (August 1 to August 14) were compared (Poisson regression analysis) with the respective average numbers during the same period in reference years 2000-2002 and 2004-2005 when there was no heat wave. Mean ages of the 3049 patients experiencing out-of-hospital cardiac arrest and the 2767 patients experiencing STEMI attended by the MICUs during the study period were 64.3 +/- 18.0 and 65.2 +/- 15.4, respectively, and two thirds were males. During the heat wave period, the number of out-of-hospital cardiac arrests (n = 40) increased 2.5-fold compared with the reference periods (n = 81 for 5 yrs; p < .001); this corresponded to an estimated relative rates of out-of-hospital cardiac arrests of 2.34 (95% confidence interval, 1.60-3.41), after adjustment for age and for gender. This increase was observed in both genders (p for interaction with gender = .48) but only in those who were aged >or=60 yrs (p for interaction with age = .005). No variation was found for myocardial infarctions during heat wave.


CONCLUSIONS
These data suggest that a heat wave may be associated with an increased risk of sudden cardiac death in the population.
Empana
Jean-Philippe
JP
INSERM U970, Paris Cardiovascular Research Centre, Paris V University, Paris, France. jeanphilippe.empana@inserm.fr
Sauval
Patrick
P
Ducimetiere
Pierre
P
Tafflet
Muriel
M
Carli
Pierre
P
Jouven
Xavier
X
D000368:Aged; D055874:Extreme Heat / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D010297:Paris