Association of diurnal temperature range with daily hospitalization for exacerbation of chronic respiratory diseases in 21 cities, China

Xianzhong Duan,Wei Hu,Pixin Ran,Longhui Tang,Yongbo Zhang,Nanshan Zhong,Huajing Yang,Yubo Ou,Xiaoliang Huang,Zhishan Deng,Yumin Zhou,Juanjuan Zheng ,Wang Xin-Wang ,Sha Li ,Calvin C.y Liao ,Zihui Wang,Fan Wu,Jieqi Peng,Long Wang,Ming Luo,Heshen Tian,Shan Xiao,Yijia Zheng,Min Xie

doi:10.1186/s12931-020-01517-7

Abstract

BackgroundThe association between diurnal temperature range (DTR) and hospitalization for exacerbation of chronic respiratory diseases (CRD) was rarely reported.ObjectivesTo examine the association between DTR and daily hospital admissions for exacerbation of CRD and find out the potential effect of modifications on this association.MethodData on daily hospitalization for exacerbation of chronic obstructive pulmonary disease (COPD), asthma and bronchiectasis and meteorology measures from 2013 through 2017 were obtained from 21 cities in South China. After controlling the effects of daily mean temperature, relative humidity (RH), particulate matter < 2.5 μm diameter (PM2.5) and other confounding factors, a standard generalized additive model (GAM) with a quasi-Poisson distribution was performed to evaluate the relationships between DTR and daily hospital admissions of CRD in a two-stage strategy. Subgroup analysis was performed to find potential modifications, including seasonality and population characteristics.ResultElevated risk of hospitalization for exacerbation of CRD (RR = 1.09 [95%CI: 1.08 to 1.11]) was associated with the increase in DTR (the 75th percentile versus the 25th percentile of DTR at lag0–6). The effects of DTR on hospital admissions for CRD were strong at low DTR in the hot season and high DTR in the cold season. The RR (the 75th percentile versus the 25th percentile of DTR at lag0–6) of hospitalization was 1.11 (95%CI: 1.08 to 1.12) for exacerbations of COPD and 1.09 (95%CI: 1.05 to 1.13) for asthma. The adverse effect of DTR on hospitalization for bronchiectasis was only observed in female patients (RR = 1.06 [95%CI: 1.03 to 1.10]).ConclusionOur study provided additional evidence for the association between DTR and daily hospitalization for exacerbation of CRD, and these associations are especially stronger in COPD patients and in the cold season than the hot season. Preventive measures to reduce the adverse impacts of DTR were needed for CRD patients.

Highlights

High prevalence of chronic respiratory diseases (CRD) has contributed to the magnitude of the non-fatal health burden globally [1]
Our study provided additional evidence for the association between diurnal temperature range (DTR) and daily hospitalization for exacerbation of CRD, and these associations are especially stronger in Chronic obstructive pulmonary disease (COPD) patients and in the cold season than the hot season
Preventive measures to reduce the adverse impacts of DTR were needed for CRD patients

Summary

Introduction

High prevalence of chronic respiratory diseases (CRD) has contributed to the magnitude of the non-fatal health burden globally [1]. Asthma is one of the most common CRD in highincome areas with a global prevalence of 4.3% (95% CI: 4.2 to 4.4) in adults [3]. Given great prevalence in both developed and developing countries, bronchiectasis is regarded as one of the most common chronic respiratory diseases [4]. As one of the severe outcomes of exacerbations, hospitalization is a major contributor to the disease burden of CRD [6]. The association between diurnal temperature range (DTR) and hospitalization for exacerbation of chronic respiratory diseases (CRD) was rarely reported

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