Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?
Identifieur interne : 002240 ( Istex/Corpus ); précédent : 002239; suivant : 002241Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?
Auteurs : Josiane Holstein ; Florence Canoui Poitrine ; Josiane Holstein ; Florence Canoui Poitrine ; Anke Neumann ; Eric Lepage ; Alfred Spira ; Alfred SpiraSource :
- Journal of Public Health [ 1741-3842 ] ; 2005-12.
English descriptors
- KwdEn :
Abstract
Objective To analyse the change of mortality rates (MRs) and their contributing medical factors among nursing home patients during the 2003 heat wave in France. Methods A retrospective observational study was conduced in all nursing homes of the Assistance-Publique-Hôpitaux de Paris (AP-HP), the French largest public hospital group. All AP-HP nursing home patients (4403) who were institutionalized in May, 2003, were concerned. The MRs of patients between three periods (before, during and after the August 2003 heat wave period) were compared according to their demographic characteristics, level of dependence and medical condition. Results The MR increased from 2.2 per cent persons month (ppm) (1.9–2.4) before heat wave up to 9.2 ppm (8.0–10.4) during heat wave and back to 2.4 ppm (2.2–2.7) after heat wave. MRs before heat wave were higher among highly dependent patients compared to those less dependent [mortality rate ratio (MRR) = 2.66 (1.69–4.21)]. This difference disappeared during the heat wave [MRR = 1.28 (0.91–1.81)] and appeared again after heat wave [MRR = 2.21 (1.52–3.23)]. The same pattern was observed for several medical conditions, such as severe malnutrition or swallowing disorders. Conclusion These results suggest that medical care during heat wave has been directed towards more fragile patients, helping to limit deaths in this group. Less frail patients made the largest contribution to excess mortality during the heat wave. During extreme weather conditions, specific attention should be paid not only to frail persons, but to all the elderly community.
Url:
DOI: 10.1093/pubmed/fdi059
Links to Exploration step
ISTEX:2221B232ABBA21F401B153E24F3CCA847441A307Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?</title><author wicri:is="90%"><name sortKey="Holstein, Josiane" sort="Holstein, Josiane" uniqKey="Holstein J" first="Josiane" last="Holstein">Josiane Holstein</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Canoui Poitrine, Florence" sort="Canoui Poitrine, Florence" uniqKey="Canoui Poitrine F" first="Florence" last="Canoui Poitrine">Florence Canoui Poitrine</name><affiliation><mods:affiliation>Florence Canouï-Poitrine, MD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</mods:affiliation></affiliation></author><author><name sortKey="Holstein, Josiane" sort="Holstein, Josiane" uniqKey="Holstein J" first="Josiane" last="Holstein">Josiane Holstein</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author><name sortKey="Canoui Poitrine, Florence" sort="Canoui Poitrine, Florence" uniqKey="Canoui Poitrine F" first="Florence" last="Canoui Poitrine">Florence Canoui Poitrine</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author><name sortKey="Neumann, Anke" sort="Neumann, Anke" uniqKey="Neumann A" first="Anke" last="Neumann">Anke Neumann</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author><name sortKey="Lepage, Eric" sort="Lepage, Eric" uniqKey="Lepage E" first="Eric" last="Lepage">Eric Lepage</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author><name sortKey="Spira, Alfred" sort="Spira, Alfred" uniqKey="Spira A" first="Alfred" last="Spira">Alfred Spira</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Spira, Alfred" sort="Spira, Alfred" uniqKey="Spira A" first="Alfred" last="Spira">Alfred Spira</name><affiliation><mods:affiliation>Alfred Spira, MD PhD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:2221B232ABBA21F401B153E24F3CCA847441A307</idno><date when="2005" year="2005">2005</date><idno type="doi">10.1093/pubmed/fdi059</idno><idno type="url">https://api.istex.fr/document/2221B232ABBA21F401B153E24F3CCA847441A307/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002240</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002240</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?</title><author wicri:is="90%"><name sortKey="Holstein, Josiane" sort="Holstein, Josiane" uniqKey="Holstein J" first="Josiane" last="Holstein">Josiane Holstein</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Canoui Poitrine, Florence" sort="Canoui Poitrine, Florence" uniqKey="Canoui Poitrine F" first="Florence" last="Canoui Poitrine">Florence Canoui Poitrine</name><affiliation><mods:affiliation>Florence Canouï-Poitrine, MD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</mods:affiliation></affiliation></author><author><name sortKey="Holstein, Josiane" sort="Holstein, Josiane" uniqKey="Holstein J" first="Josiane" last="Holstein">Josiane Holstein</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author><name sortKey="Canoui Poitrine, Florence" sort="Canoui Poitrine, Florence" uniqKey="Canoui Poitrine F" first="Florence" last="Canoui Poitrine">Florence Canoui Poitrine</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author><name sortKey="Neumann, Anke" sort="Neumann, Anke" uniqKey="Neumann A" first="Anke" last="Neumann">Anke Neumann</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author><name sortKey="Lepage, Eric" sort="Lepage, Eric" uniqKey="Lepage E" first="Eric" last="Lepage">Eric Lepage</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author><name sortKey="Spira, Alfred" sort="Spira, Alfred" uniqKey="Spira A" first="Alfred" last="Spira">Alfred Spira</name><affiliation><mods:affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Spira, Alfred" sort="Spira, Alfred" uniqKey="Spira A" first="Alfred" last="Spira">Alfred Spira</name><affiliation><mods:affiliation>Alfred Spira, MD PhD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Public Health</title><title level="j" type="abbrev">J Public Health</title><idno type="ISSN">1741-3842</idno><idno type="eISSN">1741-3850</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2005-12">2005-12</date><biblScope unit="volume">27</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="359">359</biblScope><biblScope unit="page" to="365">365</biblScope></imprint><idno type="ISSN">1741-3842</idno></series><idno type="istex">2221B232ABBA21F401B153E24F3CCA847441A307</idno><idno type="DOI">10.1093/pubmed/fdi059</idno><idno type="local">059</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1741-3842</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>heat wave</term><term>mortality</term><term>nursing home</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective To analyse the change of mortality rates (MRs) and their contributing medical factors among nursing home patients during the 2003 heat wave in France. Methods A retrospective observational study was conduced in all nursing homes of the Assistance-Publique-Hôpitaux de Paris (AP-HP), the French largest public hospital group. All AP-HP nursing home patients (4403) who were institutionalized in May, 2003, were concerned. The MRs of patients between three periods (before, during and after the August 2003 heat wave period) were compared according to their demographic characteristics, level of dependence and medical condition. Results The MR increased from 2.2 per cent persons month (ppm) (1.9–2.4) before heat wave up to 9.2 ppm (8.0–10.4) during heat wave and back to 2.4 ppm (2.2–2.7) after heat wave. MRs before heat wave were higher among highly dependent patients compared to those less dependent [mortality rate ratio (MRR) = 2.66 (1.69–4.21)]. This difference disappeared during the heat wave [MRR = 1.28 (0.91–1.81)] and appeared again after heat wave [MRR = 2.21 (1.52–3.23)]. The same pattern was observed for several medical conditions, such as severe malnutrition or swallowing disorders. Conclusion These results suggest that medical care during heat wave has been directed towards more fragile patients, helping to limit deaths in this group. Less frail patients made the largest contribution to excess mortality during the heat wave. During extreme weather conditions, specific attention should be paid not only to frail persons, but to all the elderly community.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Josiane Holstein</name><affiliations><json:string>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</json:string></affiliations></json:item><json:item><name>Florence Canouï-Poitrine</name><affiliations><json:string>Florence Canouï-Poitrine, MD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</json:string></affiliations></json:item><json:item><name>Josiane Holstein</name><affiliations><json:string>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</json:string></affiliations></json:item><json:item><name>Florence Canouï-Poitrine</name><affiliations><json:string>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</json:string></affiliations></json:item><json:item><name>Anke Neumann</name><affiliations><json:string>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</json:string></affiliations></json:item><json:item><name>Eric Lepage</name><affiliations><json:string>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</json:string></affiliations></json:item><json:item><name>Alfred Spira</name><affiliations><json:string>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</json:string></affiliations></json:item><json:item><name>Alfred Spira</name><affiliations><json:string>Alfred Spira, MD PhD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>heat wave</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>mortality</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>nursing home</value></json:item></subject><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Objective To analyse the change of mortality rates (MRs) and their contributing medical factors among nursing home patients during the 2003 heat wave in France. Methods A retrospective observational study was conduced in all nursing homes of the Assistance-Publique-Hôpitaux de Paris (AP-HP), the French largest public hospital group. All AP-HP nursing home patients (4403) who were institutionalized in May, 2003, were concerned. The MRs of patients between three periods (before, during and after the August 2003 heat wave period) were compared according to their demographic characteristics, level of dependence and medical condition. Results The MR increased from 2.2 per cent persons month (ppm) (1.9–2.4) before heat wave up to 9.2 ppm (8.0–10.4) during heat wave and back to 2.4 ppm (2.2–2.7) after heat wave. MRs before heat wave were higher among highly dependent patients compared to those less dependent [mortality rate ratio (MRR) = 2.66 (1.69–4.21)]. This difference disappeared during the heat wave [MRR = 1.28 (0.91–1.81)] and appeared again after heat wave [MRR = 2.21 (1.52–3.23)]. The same pattern was observed for several medical conditions, such as severe malnutrition or swallowing disorders. Conclusion These results suggest that medical care during heat wave has been directed towards more fragile patients, helping to limit deaths in this group. Less frail patients made the largest contribution to excess mortality during the heat wave. During extreme weather conditions, specific attention should be paid not only to frail persons, but to all the elderly community.</abstract><qualityIndicators><score>8.715</score><pdfVersion>1.5</pdfVersion><pdfPageSize>612 x 788 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>1592</abstractCharCount><pdfWordCount>3823</pdfWordCount><pdfCharCount>23716</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>241</abstractWordCount></qualityIndicators><title>Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?</title><refBibs><json:item><host><volume>52</volume><pages><first>3</first></pages><author></author><title>Rev Epidemiol Sante Publique</title></host></json:item><json:item><host><pages><first>226</first></pages><author></author><title>Bull Epidemiologique Hebdomadaire</title></host></json:item><json:item><host><volume>25</volume><pages><first>559</first></pages><author></author><title>Revue Geriatrie</title></host></json:item><json:item><host><volume>15</volume><pages><first>40</first></pages><author></author><title>Sante Publique</title></host></json:item><json:item><host><volume>19</volume><pages><first>249</first></pages><author></author><title>Revue Gériatrie</title></host></json:item><json:item><host><pages><first>1</first></pages><author></author><title>The design and analysis of cohort studies</title></host></json:item><json:item><host><volume>335</volume><pages><first>84</first></pages><author></author><title>N Engl J Med</title></host></json:item><json:item><host><volume>30</volume><pages><first>1</first></pages><author></author><title>Intensive Care Med</title></host></json:item><json:item><host><volume>12</volume><pages><first>662</first></pages><author></author><title>Epidemiology</title></host></json:item><json:item><host><volume>70</volume><pages><first>105</first></pages><author></author><title>Environ Res</title></host></json:item><json:item><host><volume>4</volume><pages><first>58</first></pages><author></author><title>Sante Publique</title></host></json:item><json:item><host><pages><first>1</first></pages><author></author><title>Etudes Statistiques</title></host></json:item><json:item><host><volume>42</volume><pages><first>972</first></pages><author></author><title>J Am Geriatr Soc</title></host></json:item><json:item><host><volume>1</volume><pages><first>229</first></pages><author></author><title>Environnement, Risques Sante</title></host></json:item><json:item><host><volume>24</volume><pages><first>190</first></pages><author></author><title>Epidemiol Rev</title></host></json:item><json:item><host><volume>24</volume><pages><first>190</first></pages><author></author><title>N Engl J Med</title></host></json:item><json:item><host><volume>46</volume><pages><first>145</first></pages><author></author><title>Int J Biometeorol</title></host></json:item><json:item><host><volume>22</volume><pages><first>328</first></pages><author></author><title>Am J Prev Med</title></host></json:item><json:item><host><volume>30</volume><pages><first>148</first></pages><author></author><title>Ann Acad Med Singapore</title></host></json:item><json:item><host><volume>12</volume><pages><first>420</first></pages><author></author><title>An Med Interna</title></host></json:item><json:item><host><volume>22</volume><pages><first>196</first></pages><author></author><title>Am J Forensic Med Pathol</title></host></json:item><json:item><host><volume>8</volume><pages><first>195</first></pages><author></author><title>J Am Board Fam Pract</title></host></json:item><json:item><host><volume>21</volume><pages><first>69</first></pages><author></author><title>An Med Interna</title></host></json:item><json:item><host><volume>42</volume><pages><first>44</first></pages><author></author><title>Int J Biometeorol</title></host></json:item><json:item><host><volume>71</volume><pages><first>219</first></pages><author></author><title>Theor Appl Climatol</title></host></json:item><json:item><host><volume>247</volume><pages><first>27</first></pages><author></author><title>JAMA</title></host></json:item><json:item><host><pages><first>245</first></pages><author></author><title>The public health consequences of disasters</title></host></json:item><json:item><host><volume>33</volume><pages><first>13</first></pages><author></author><title>Presse Med</title></host></json:item></refBibs><genre><json:string>research-article</json:string></genre><host><volume>27</volume><publisherId><json:string>pubmed</json:string></publisherId><pages><last>365</last><first>359</first></pages><issn><json:string>1741-3842</json:string></issn><issue>4</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1741-3850</json:string></eissn><title>Journal of Public Health</title></host><categories><wos><json:string>social science</json:string><json:string>public, environmental & occupational health</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>public health & health services</json:string><json:string>public health</json:string></scienceMetrix></categories><publicationDate>2005</publicationDate><copyrightDate>2005</copyrightDate><doi><json:string>10.1093/pubmed/fdi059</json:string></doi><id>2221B232ABBA21F401B153E24F3CCA847441A307</id><score>1.4922191</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/2221B232ABBA21F401B153E24F3CCA847441A307/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/2221B232ABBA21F401B153E24F3CCA847441A307/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/2221B232ABBA21F401B153E24F3CCA847441A307/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>© The Author 2005, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.</p></availability><date>2005-10-18</date></publicationStmt><notesStmt><note>Address correspondence to Josiane Holstein. Email: josiane.holstein@sap.ap-hop-paris.fr</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?</title><author xml:id="author-1"><persName><forename type="first">Josiane</forename><surname>Holstein</surname></persName><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation></author><author xml:id="author-2"><persName><forename type="first">Florence</forename><surname>Canouï-Poitrine</surname></persName><affiliation>Florence Canouï-Poitrine, MD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</affiliation></author><author xml:id="author-3"><persName><forename type="first">Josiane</forename><surname>Holstein</surname></persName><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation></author><author xml:id="author-4"><persName><forename type="first">Florence</forename><surname>Canouï-Poitrine</surname></persName><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation></author><author xml:id="author-5"><persName><forename type="first">Anke</forename><surname>Neumann</surname></persName><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation></author><author xml:id="author-6"><persName><forename type="first">Eric</forename><surname>Lepage</surname></persName><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation></author><author xml:id="author-7"><persName><forename type="first">Alfred</forename><surname>Spira</surname></persName><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation></author><author xml:id="author-8"><persName><forename type="first">Alfred</forename><surname>Spira</surname></persName><affiliation>Alfred Spira, MD PhD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</affiliation></author></analytic><monogr><title level="j">Journal of Public Health</title><title level="j" type="abbrev">J Public Health</title><idno type="pISSN">1741-3842</idno><idno type="eISSN">1741-3850</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2005-12"></date><biblScope unit="volume">27</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="359">359</biblScope><biblScope unit="page" to="365">365</biblScope></imprint></monogr><idno type="istex">2221B232ABBA21F401B153E24F3CCA847441A307</idno><idno type="DOI">10.1093/pubmed/fdi059</idno><idno type="local">059</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2005-10-18</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective To analyse the change of mortality rates (MRs) and their contributing medical factors among nursing home patients during the 2003 heat wave in France. Methods A retrospective observational study was conduced in all nursing homes of the Assistance-Publique-Hôpitaux de Paris (AP-HP), the French largest public hospital group. All AP-HP nursing home patients (4403) who were institutionalized in May, 2003, were concerned. The MRs of patients between three periods (before, during and after the August 2003 heat wave period) were compared according to their demographic characteristics, level of dependence and medical condition. Results The MR increased from 2.2 per cent persons month (ppm) (1.9–2.4) before heat wave up to 9.2 ppm (8.0–10.4) during heat wave and back to 2.4 ppm (2.2–2.7) after heat wave. MRs before heat wave were higher among highly dependent patients compared to those less dependent [mortality rate ratio (MRR) = 2.66 (1.69–4.21)]. This difference disappeared during the heat wave [MRR = 1.28 (0.91–1.81)] and appeared again after heat wave [MRR = 2.21 (1.52–3.23)]. The same pattern was observed for several medical conditions, such as severe malnutrition or swallowing disorders. Conclusion These results suggest that medical care during heat wave has been directed towards more fragile patients, helping to limit deaths in this group. Less frail patients made the largest contribution to excess mortality during the heat wave. During extreme weather conditions, specific attention should be paid not only to frail persons, but to all the elderly community.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>heat wave</term></item><item><term>mortality</term></item><item><term>nursing home</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-10-18">Created</change><change when="2005-12">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/2221B232ABBA21F401B153E24F3CCA847441A307/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="US-ASCII"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jphm</journal-id><journal-id journal-id-type="nlm-ta">J Public Health (Oxf)</journal-id><journal-id journal-id-type="publisher-id">pubmed</journal-id><journal-title>Journal of Public Health</journal-title><abbrev-journal-title abbrev-type="publisher">J Public Health</abbrev-journal-title><issn pub-type="ppub">1741-3842</issn><issn pub-type="epub">1741-3850</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">059</article-id><article-id pub-id-type="doi">10.1093/pubmed/fdi059</article-id><article-categories><subj-group subj-group-type="heading"><subject>Health protection</subject></subj-group></article-categories><title-group><article-title>Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Holstein</surname><given-names>Josiane</given-names></name></contrib><aff>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Canouï-Poitrine</surname><given-names>Florence</given-names></name></contrib><aff>Florence Canouï-Poitrine, MD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Neumann</surname><given-names>Anke</given-names></name></contrib><contrib contrib-type="author"><name><surname>Lepage</surname><given-names>Eric</given-names></name></contrib><aff>Anke Neumann, PhD, Eric Lepage, MD PhD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Spira</surname><given-names>Alfred</given-names></name></contrib><aff>Alfred Spira, MD PhD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</aff></contrib-group><author-notes><corresp>Address correspondence to Josiane Holstein. Email: <ext-link xlink:href="josiane.holstein@sap.ap-hop-paris.fr" ext-link-type="email">josiane.holstein@sap.ap-hop-paris.fr</ext-link></corresp></author-notes><pub-date pub-type="epub"><day>18</day><month>10</month><year>2005</year></pub-date><pub-date pub-type="ppub"><month>December</month><year>2005</year></pub-date><volume>27</volume><issue>4</issue><fpage>359</fpage><lpage>365</lpage><permissions><copyright-statement>© The Author 2005, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.</copyright-statement><copyright-year>2005</copyright-year></permissions><abstract xml:lang="en"><p><bold>Objective</bold> To analyse the change of mortality rates (MRs) and their contributing medical factors among nursing home patients during the 2003 heat wave in France.</p><p><bold>Methods</bold> A retrospective observational study was conduced in all nursing homes of the Assistance-Publique-Hôpitaux de Paris (AP-HP), the French largest public hospital group. All AP-HP nursing home patients (4403) who were institutionalized in May, 2003, were concerned. The MRs of patients between three periods (before, during and after the August 2003 heat wave period) were compared according to their demographic characteristics, level of dependence and medical condition.</p><p><bold>Results</bold> The MR increased from 2.2 per cent persons month (ppm) (1.9–2.4) before heat wave up to 9.2 ppm (8.0–10.4) during heat wave and back to 2.4 ppm (2.2–2.7) after heat wave. MRs before heat wave were higher among highly dependent patients compared to those less dependent [mortality rate ratio (MRR) = 2.66 (1.69–4.21)]. This difference disappeared during the heat wave [MRR = 1.28 (0.91–1.81)] and appeared again after heat wave [MRR = 2.21 (1.52–3.23)]. The same pattern was observed for several medical conditions, such as severe malnutrition or swallowing disorders.</p><p><bold>Conclusion</bold> These results suggest that medical care during heat wave has been directed towards more fragile patients, helping to limit deaths in this group. Less frail patients made the largest contribution to excess mortality during the heat wave. During extreme weather conditions, specific attention should be paid not only to frail persons, but to all the elderly community.</p></abstract><kwd-group kwd-group-type="KWD" xml:lang="en"><kwd>heat wave</kwd><kwd>mortality</kwd><kwd>nursing home</kwd></kwd-group><custom-meta-wrap><custom-meta><meta-name>hwp-legacy-fpage</meta-name><meta-value>359</meta-value></custom-meta><custom-meta><meta-name>cover-date</meta-name><meta-value>December 2005</meta-value></custom-meta><custom-meta><meta-name>hwp-legacy-dochead</meta-name><meta-value>Article</meta-value></custom-meta></custom-meta-wrap></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?</title></titleInfo><name type="personal"><namePart type="given">Josiane</namePart><namePart type="family">Holstein</namePart><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation></name><name type="personal"><namePart type="given">Florence</namePart><namePart type="family">Canouï-Poitrine</namePart><affiliation>Florence Canouï-Poitrine, MD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</affiliation></name><name type="personal"><namePart type="given">Josiane</namePart><namePart type="family">Holstein</namePart><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Florence</namePart><namePart type="family">Canouï-Poitrine</namePart><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Anke</namePart><namePart type="family">Neumann</namePart><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Eric</namePart><namePart type="family">Lepage</namePart><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alfred</namePart><namePart type="family">Spira</namePart><affiliation>Josiane Holstein, MD, Department of Medical Information, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris Cedex 04, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alfred</namePart><namePart type="family">Spira</namePart><affiliation>Alfred Spira, MD PhD, Epidemiology and Public Health Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex 08, France</affiliation></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2005-12</dateIssued><dateCreated encoding="w3cdtf">2005-10-18</dateCreated><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Objective To analyse the change of mortality rates (MRs) and their contributing medical factors among nursing home patients during the 2003 heat wave in France. Methods A retrospective observational study was conduced in all nursing homes of the Assistance-Publique-Hôpitaux de Paris (AP-HP), the French largest public hospital group. All AP-HP nursing home patients (4403) who were institutionalized in May, 2003, were concerned. The MRs of patients between three periods (before, during and after the August 2003 heat wave period) were compared according to their demographic characteristics, level of dependence and medical condition. Results The MR increased from 2.2 per cent persons month (ppm) (1.9–2.4) before heat wave up to 9.2 ppm (8.0–10.4) during heat wave and back to 2.4 ppm (2.2–2.7) after heat wave. MRs before heat wave were higher among highly dependent patients compared to those less dependent [mortality rate ratio (MRR) = 2.66 (1.69–4.21)]. This difference disappeared during the heat wave [MRR = 1.28 (0.91–1.81)] and appeared again after heat wave [MRR = 2.21 (1.52–3.23)]. The same pattern was observed for several medical conditions, such as severe malnutrition or swallowing disorders. Conclusion These results suggest that medical care during heat wave has been directed towards more fragile patients, helping to limit deaths in this group. Less frail patients made the largest contribution to excess mortality during the heat wave. During extreme weather conditions, specific attention should be paid not only to frail persons, but to all the elderly community.</abstract><note type="author-notes">Address correspondence to Josiane Holstein. Email: josiane.holstein@sap.ap-hop-paris.fr</note><subject lang="en"><genre>KWD</genre><topic>heat wave</topic><topic>mortality</topic><topic>nursing home</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Public Health</title></titleInfo><titleInfo type="abbreviated"><title>J Public Health</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1741-3842</identifier><identifier type="eISSN">1741-3850</identifier><identifier type="PublisherID">pubmed</identifier><identifier type="PublisherID-hwp">jphm</identifier><identifier type="PublisherID-nlm-ta">J Public Health (Oxf)</identifier><part><date>2005</date><detail type="volume"><caption>vol.</caption><number>27</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>359</start><end>365</end></extent></part></relatedItem><identifier type="istex">2221B232ABBA21F401B153E24F3CCA847441A307</identifier><identifier type="DOI">10.1093/pubmed/fdi059</identifier><identifier type="local">059</identifier><accessCondition type="use and reproduction" contentType="copyright">© The Author 2005, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.</accessCondition><recordInfo><recordContentSource>OUP</recordContentSource></recordInfo></mods></metadata><covers><json:item><extension>tiff</extension><original>true</original><mimetype>image/tiff</mimetype><uri>https://api.istex.fr/document/2221B232ABBA21F401B153E24F3CCA847441A307/covers/tiff</uri></json:item></covers><annexes><json:item><extension>jpeg</extension><original>true</original><mimetype>image/jpeg</mimetype><uri>https://api.istex.fr/document/2221B232ABBA21F401B153E24F3CCA847441A307/annexes/jpeg</uri></json:item><json:item><extension>gif</extension><original>true</original><mimetype>image/gif</mimetype><uri>https://api.istex.fr/document/2221B232ABBA21F401B153E24F3CCA847441A307/annexes/gif</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonFranceV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002240 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 002240 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= ParkinsonFranceV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:2221B232ABBA21F401B153E24F3CCA847441A307
|texte= Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?
}}
| This area was generated with Dilib version V0.6.29. |  |