Identifying heat-related diagnoses in emergency department visits among adults in Chicago: a heat-wide association study

TL;DR

This study uses a comprehensive heat-wide association approach to identify and quantify the impact of extreme heat on various acute-care diagnoses among adults in Chicago, revealing specific health conditions linked to heat exposure.

Contribution

It introduces a novel heat-wide association methodology that captures a broad spectrum of heat-related diagnoses beyond traditional categories, improving heat-health risk assessment.

Findings

Increased same-day visits for heat illness and dehydration.

Identification of new heat-associated diagnoses like acute kidney failure.

Quantitative estimates of odds ratios for heat-related health conditions.

Abstract

Extreme heat is an escalating public health concern. Although prior studies have examined heat-health associations, their reliance on restricted diagnoses and diagnostic categories misses or misclassifies heat-related illness. We conducted a heat-wide association study to identify acute-care diagnoses associated with extreme heat in Chicago, Illinois. Using 916,904 acute-care visits -- including emergency department and urgent care encounters -- among 372,140 adults across five healthcare systems from 2011-2023, we applied a two-stage analytic approach: quasi-Poisson regression to screen 1,803 diagnosis codes for heat-related risks, followed by distributed lag non-linear models in a time-stratified case-crossover design to refine the list of heat-related diagnoses and estimate same-day and short-term cumulative odds ratios of acute-care visits during extreme heat versus reference temperature. We observed same-day increases in visits for heat illness, volume depletion, hypotension, edema, acute kidney failure, and multiple injuries. By analyzing the full diagnostic spectrum of acute-care services, this study comprehensively characterizes heat-associated morbidity, reinforcing and advancing existing literature.