PREDICTORS OF ADMISSION/NON-ADMISSION INTO THE HOSPITAL, HEALTH EFFECTS, AND METEOROLOGICAL FACTORS RELATED TO A VIOLENT STORM IN TIMISOARA, ROMANIA
Abstract
The aim of the performed study is to investigate predictors of admission/non-admission into the hospital, health effects and meteorological factors related to a violent storm that happened on the 17th of September 2017, in Timisoara, Romania. Materials and methods: Case-study with a 6-day retrospective investigation (15th-20th September) of admissions/non-admissions, all health effects and storm-trauma health effects, and meteorological factors on a sample of 1,156 patients (54.93% males, 45.07% females) who came to the ERU, sample that included a “storm-trauma” sample of 71 patients (60.60% males, 39.40% females). Results: Three subgroups of the entire sample were considered: before storm-no effects (15th-16th), during and after the storm-immediate effects (17th-18th and after the storm-delayed effects (19th-20th of September). Traumatic health effects (16.7% of trauma, 13.3%-due to the storm) and meteorological factors values (air temperature-31.60C, air pressure-732 mmHg, gust wind speed-106.92 Km/h-violent storm) were recorded on the 17th of September. Discussion: Main predictors for admission into the hospital were covariate: mean air temperature (OR=1.924, P<0.001), relative humidity and age increase, and categorical: cardiac diseases (OR=0.436, P<0.001), fractures (OR=0.375, P<0.001), and urban/rural environment. A primary categorical predictor for non-admission into the hospital was contusions. A subgroup of population exposed to the storm (17th-18th of September) recorded significant differences in term of being admitted into the hospital in comparison with the other two subgroups. Conclusions: there is a relation between admissions/non-admissions into the hospital and personal characteristics (age, rural/urban), health effects (cardiac diseases, fractures, contusions), and meteorological factors (air temperature, humidity, pressure) in the context of the violent-storm.
References
2. News Pro TV. 8 dead and 137 injured after Sunday's storm. [8 morti si 137 de răniți după furtuna de duminică]. [Internet] Romania: News Pro TV 2017. [cited 2024 January 5]. Available from: /stirileprotv.ro/stiri/actualitate/bilantul-furtunii-de-duminica-seara-din-timis.
3. Gad-el-Hak M. Large scale disasters. Prediction, control and mitigation. Virginia, US: Cambridge University Press, 2008 / doi: 10.1017/CBO9780511535963
4. Peijun, S. Hazards, disasters, and risks. Disaster Risk Science 2019; online:1-48 / doi: 10.1007/978-981-13-6689-51.
5. Working Group II, Instrumental panel of climate change (IPCC). Climate Change 2022: Impacts, Adaptation and Vulnerability. Chapter 7. Impacts, Adaptation and Vulnerability. [Internet]. Online meeting: The second part of the Sixth Assessment Report, February 2022. [cited 2024 January 5]. Available from: /www.ipcc.ch/report/ar6/wg2/.
6. Junlapeeya P, Lorga T, Santiprasitkul P, Tonkuriman A. A Descriptive Qualitative Study of Older Persons and Family Experiences with Extreme Weather Conditions in Northern Thailand. Int J Environ Res Public Health 2023; 20(12): 6167 / doi: 10.3390/ijerph 20 12 6167.
7. Marchigiani R, Gordy S, Cipolla J. Wind disasters: a comprehensive review of current management strategies. International Journal of Critical Illness and Injury Science 2013; 3(2): 130-142 / doi: 10.4103/2229-5151.114273.
8. Antonescu B, Bell A. Tornadoes in Romania. Journals of American Meteorological Society 2015; online / doi: 10.1175/MWR-D-14-00181.1.
9. Cristea A. A year of calamities: the Romanian experience. In Extreme weather and climate events and public health responses WHO 2004 March 10- Bratislava, Slovakia organized by WHO European Centre for Environment and Health, Rome Office. Published in Report on WHO, 2004; Session 5. Na-tional case-studies on health care systems responses to extreme weather events. online: 35. [cited 2024 January 5]. Available from: /www.eird.org/isdr-biblio/PDF/Extreme%20weather% 20and% 20climate%20events.pdf.
10. Malilay J, Heumann M, Perrotta D, et al. The role of applied epidemiology methods in the disaster management cycle. American Journal of Public Health 2014; 104(11): 2092-2102 / doi:10.2105 /AJPH. 2014.302010.
11. Lund Research Ltd. Binomial Logistic Regression using SPSS Statistics. 2018. [Cited 2024 January 5]. Available from /statistics.laerd.com/spss-tutorials/binomial-logistic-regression-using-spss-statistics.php.
12. Andrew E, Nehme Z, Bernard S, et al. Stormy weather: a retrospective analysis of demand for emer-gency medical services during epidemic thunderstorm asthma. BMJ 2017; 359: j5636.
13. Ghazali DA, Guericolas M, Thys F, Sarasin F, Arcos González P, Casalino E. Climate change impacts on disaster and emergency medicine focusing on mitigation disruptive effects: an international perspective. International Journal of Environmental Research and Public Health 2018; 15(7): 1379 / doi: 10.3390/ijerph15071379.
14. Biber R, Bail HJ, Sieber C, Weis P, Christ M, Singler K. Correlation between age, emergency de-partment length of stay and hospital admission rate in emergency department patients aged ≥70 Years. Gerontology 2013; 59(1): 17-22 / doi: 10.1159/000342202.
15. Weinberger KR, Kulick ER, Boehme AK, Sun S, Dominici F, Wellenius GA. Association Between Hurricane Sandy and Emergency Department Visits in New York City by Age and Cause. Am J Epi-demiol 2021; 190(10): 2138-2147 / doi: 10.1093/aje/kwab127.
16. Wright DW, Espinoza TR, Merck LH, Ratcliff JJ, Backster A, Stein DG. Gender differences in neu-rological emergencies Part II: a consensus summary and research agenda in traumatic brain injury. Academic Emergency Medicine 2014; 21(12): 1414-1420 / doi: 10.1111/acem.12532.
17. Hu J, Chen C, Kuai T. Improvement of emergency management mechanism of public health crisis in rural China: a review article. Iranian Journal Public Health 2018; 47(2): 156-165.
18. Van Minh H, Tuan Anh T, Rocklöv J, et al. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam. Global Health Action 2014; 7(23007) / doi: 10.3402/gha.v7.23007.e Collection.
19. Zhiheng Z, Caizia W, Jiaji W, Huajie Y, Chao W, Wannian L. The knowledge, attitude and behavior about public health emergencies and the response capacity of primary care staffs in Guangdong prov-ince, China. BMC Health Service Research 2012; 12: 338.
20. Aldridge C, Bion J, Boyal A, et al. Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study. The Lancet 2016; 388(10040): 178-186 / doi:10.1016/ S0140-6736(16)30442-1.
21. Vest-Hansen B, Riis AH, Sørensen HT, Christiansen CF. Out-of-hours weekend admissions to Danish medical departments: admission rates and 30-day mortality for 20 common medical conditions. BMJ Open 2015; 5(3): e006731 / doi: 10.1136/bmjopen-2014-006731.
22. Stefanovski PH, Radkov RV, Ilkov TL, et al. Analysis of mortality in the emergency department at a University Hospital in Pleven. Journal of International Medical Research 2017; 45(5): 1553-1561 / doi: 10.1177/0300060517707901.
23. Baidwan NK, Naranie SM. Epidemiology and recent trends of geriatric fractures presenting to the emergency department for United States population from year 2004-2014. Public Health 2017; 142: 64-69 / doi: 10.1016/j.puhe.2016.10.018.
24. Wang FT, Chang Y, Chien WC, Li HH. Injury and medical expenditure in emergency department visits of older veterans. Geriatric Gerontology International 2016; 16(12): 1254-1262 / doi: 10.1111/ggi. 12620.
25. Bosch M, McKenzie JE, Mortimer D, et al. Implementing evidence-based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: study protocol for a cluster randomized control trial. Trials 2014; 15: 28.
26. Dunn MJG, Gwinnutt CL, Gray AJ. Critical care in Emergency Department: patient transfer. Emer-gency Medicine Journal 2007; 24(1): 40-44 / doi:10.1136/emj.2006.042044.
27. Pan CL, Chiu CV, Wen JC. Adaptation and Promotion of Emergency Medical Service Transportation for Climate Change. Medicine (Baltimore) 2014; 93(27): e186 / doi: 10.1097/ MD.0000000000000186.
28. Mohanty CR, Jain M, Radhakrishnan RV, Mohanty PC, Panda R. Tropical cyclone Fani-perspective from the trauma and emergency department of an affected tertiary hospital. Chin J Traumatol 2020; 23(4): 243-248 / doi: 10.1016/j.cjtee.2020.04.002.
29. Brubaker M, Berner J, Chavan R, Warren J. Climate change and health effects in Northwest Alaska. Global Health Action 2011; 4 / doi: 10.3402/gha.v4i0.8445.
30. Wang L, Liao Y, Yang L, Li H, Ye B, Wang W. Emergency response to and preparedness for extreme weather events and environmental changes in China. Asia Pacific Journal of Public Health 2016; 28(2S):5 9S-66S / doi: 10.1177/1010539514549763.
31. Bezirtzoglou C, Dekas K, Charvalos E. Climate changes, environment and infection: facts, scenarios and growing awareness from the public health community within Europe. Anaerobe 2011; 17(6): 337-340 / doi: 10.1016/j.anaerobe.2011.05.016.
32. Hammer CC, Brainard J, Hunter PR. Risk factors and risk factor cascades for communicable disease outbreaks in complex humanitarian emergencies: a qualitative systematic review. BMJ Global Health 2018: 3(4): e000647 / doi: 10.1136/bmjgh-2017-000647.
33. Lemon DJ, Partridge R, The Pan-Dorset Cardiff Model team. Is weather related to the number of assaults seen at emergency departments? Elsevier Injury 2017; 48(11): 2438-2442 / doi: 10.1016/j.injury. 2017.08.038.
34. Keim ME. Preventing disasters: public health vulnerability reduction as a sustainable adaptation to climate change. Disaster Medicine and Public Health Preparedness 2011; 5(2): 140-148 /doi: 10.1001/dmp.2011.30.
35. Ebi KL. Resilience to the health risks of extreme weather events in a changing climate in the United State. International Journal of Environmental Research and Public Health 2011; 8(12): 4582-4595 / doi: 10.3390/ijerph8124582.
36. Bathi JR, Das HS. Vulnerability of coastal communities from storm surge and flood disasters. Inter-national Journal of Environmental Research and Public Health 2016; 13(2): 239 / doi: 10.3390/ ijerph13020239.
37. Banwell N, Rutherford S, Mackey B, Chu C. Towards improved linkage of disaster risk reduction and climate change adaptation in health: a review. International Journal of Environmental Research and Public Health 2018; 15(4): E793 / doi: 10.3390/ijerph15040 793.
38. Tarnoki AD, Türker A, Tarnoki DL, et al. Relationship between weather conditions and admissions for ischemic stroke and subarachnoid hemorrhage. Croatian Medical Journal 2017: 58(1): 56-62 / doi: 10.3325/cmj.2017.58.56.29.
39. McMichael AJ. Extreme weather events and infectious disease outbreaks. Virulence 2015; 6(6): 543-547 / doi: 10.4161/21505594.

Additional Files
Published
Issue
Section
License
COPYRIGHT
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
_____________________________________________________________________________________
_____________________________________________________________________________________
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
- ______________________________/_________________________
- ______________________________/_________________________
- ______________________________/_________________________
N.B. All the authors must sign this form