The impact of non-optimum temperatures, heatwaves and cold spells on out-of-hospital cardiac arrest onset in a changing climate in China: a multi-center, time-stratified, case-crossover study

作者：Jiangdong Liu, Chuanzhu Lv, Jiaqi Zheng, Chang Pan, Guoqiang Zhang, Huiqiong Tan, Yu Ma, Yimin Zhu, Xiaotong Han, Chaoqian Li, Shengtao Yan, Jingjing Ma, Jianbo Zhang, Chunyi Wang, Yuan Bian, Kai Cheng, Rugang Liu, Yaping Hou, Qiran Chen, Xuan Zhang, Yuguo Chen, Renjie Chen, Feng Xu · 发表于：The Lancet Regional Health - Western Pacific · 年份：2023 · DOI：10.1016/j.lanwpc.2023.100778 · 被引用次数：17 · 研究领域：Cardiac Arrest and Resuscitation、Climate Change and Health Impacts、Thermal Regulation in Medicine

Background: Out-of-hospital cardiac arrest (OHCA) is a time-critical and fatal medical emergency that has been linked to non-optimal temperatures. However, the future burden of OHCA due to non-optimal temperatures, heatwaves, and cold spells under climate change has not been well evaluated. Methods: We conducted a time-stratified case-crossover study in 15 Northern Chinese cities throughout 2020 to estimate the exposure-response relationships of non-optimal temperatures, heatwaves, and cold spells with hourly OHCA onset in hot and cold seasons. We obtained future daily average temperatures by using 20 general circulation models under two greenhouse gas emission scenarios: one with certain emission control and the other with relaxed control. Lastly, we projected the change of OHCA burden under these two climate scenarios. Findings: We analyzed a total of 29,671 OHCA patients and found that high temperatures and heatwaves as well as low temperatures and cold spells were all significantly associated with an increased risk of OHCA onset. Under the scenario of uncontrolled emissions, the attributable fraction (AF) of OHCA due to high temperatures and heatwaves would increase by 4.94% and 6.99% from the 2010s to 2090s, respectively. The AF due to low temperatures would decrease by 1.27% by the 2090s and the effects of cold spells were projected to be marginal after the 2050s. Under a medium emission control scenario, the upward trend of heat-related OHCA burden would become flat, a...