RISK FACTORS OF MORTALITY DURING THE HEAT WAVE OF AUGUST 2003 IN FRANCE’S NURSING HOMESстатья из журнала
Аннотация: ISEE-553 Introduction: An unprecedented heat wave came about in France during the month of August 2003, causing an excess mortality of nearly 15 000 deaths, including 5 000 among people living in nursing homes. The purpose of this study is to estimate risk factors of heat wave related mortality within the elderly population living in nursing homes: individual risk factors (autonomy/handicap, medical condition, drug consumption) and environmental risk factors (architectural characteristics of the nursing home; prevention plans and therapeutic protocols). Methods: We conducted a random case-control study in 11 of 22 French regions where the heat wave and the total number of death were the highest. 175 nursing homes were selected on the basis of a postal survey conducted in August 2003 taking the ones with the highest mortality rate weighted by a French autonomy score for each facility. The target facilities are retirement homes and hospital units for the long term care of the elderly in this area. Data were collected by interview of medical staff. A matched pairs analysis on age and nursing home was used to estimate odds ratios and confidence intervals. Odds ratios were adjusted on sex and being “bedridden”. Results: We selected 314 cases and 314 matched controls. The mean of age was 87.6 year and 80% of the controls were women. Half of the subject of the sample need help to stand up or stay in a wheel chair (OR= 1.7 [1.1; 2.6].) One fifth was bedridden (OR= 6.0 [3.4; 10.6]). Access to air conditioning was possible for only 8% of the subject (OR= 0.2 [0.1; 0.2]). Increase non alcoholic beverage during the heat wave (OR= 0.3 [0.1; 0.6]), possibility to get out of their room (OR= 0.1 [0.1; 0.2]) and for those who were not bedridden having a shower more than once a week OR=0.4 [0.2; 0.8]) were strongly associated with lower risk of death. Social contact (to participate to the organized activity of nursing home (OR= 0.6 [0.4; 0.9], having more than one child (OR= 0.7 [0.5; 1.0]) and state of malnutrition (OR= 4.0 [2.3; 7.2]) were also important factors linked to vital status. Concerning architectural factors, living under the roof was borderline significant (OR= 1.5 [1.0; 2.3] p=0.06). Having a window with East orientation was also linked to death (OR = 1.5 [1.0; 2.3]). Discussion: Very few studies have explored the health related factors of heat wave mortality in nursing home. The first results show a very particular population with a very high level of dependency, and bad health status (malnutrition, bedsores). Very few organizational or architectural factors could be evidenced probably due to matching on nursing home. Impact of nursing home staff interventions cannot be evaluated mostly because they have been implemented after the first heat wave related symptoms. Autonomy and health status seem to have considerable impact on heat wave related death.
Год издания: 2004
Авторы: C Lorente, C. Sérazin, Delphine Daube, Hélène Tillaut, Georges Salines
Издательство: Lippincott Williams & Wilkins
Источник: Epidemiology
Ключевые слова: Climate Change and Health Impacts
Другие ссылки: Epidemiology (HTML)
journals.lww.com (HTML)
journals.lww.com (HTML)
Открытый доступ: bronze
Том: 15
Выпуск: 4
Страницы: S217–S217