Children’s Emergency Department Visits for Heat-related Illnesses Increased 170% Over Past Decade

Research from two large children’s hospitals presented during American Academy of Pediatrics 2024 National Conference & Exhibition

ORLANDO, Fla.—The number of children who sought treatment at emergency departments for heat-related illnesses increased by 170% from 2012-2023 at two large children’s hospitals, according to research presented during the American Academy of Pediatrics 2024 National Conference & Exhibition in Orlando, FL.

The study abstract, “Trends and Outcomes of Heat-Related Illnesses at a Tertiary Children’s Hospital System in the Southern United States, 2012-2023,” examines recent trends, demographics, and outcomes in children with heat-related illness.

The AAP conference takes place at the Orange County Convention Center from Sept. 27-Oct. 1.

“As pediatricians, we see firsthand how excessive heat affects children’s health,” said Taylor Merritt, MD.  “The significant rise in heat-related illnesses over the past decade underscores a growing public health concern that warrants further attention and action." 

Summer months with higher peak temperatures were associated with higher heat-related emergency department volume, the abstract states. 

In all, researchers analyzed 542 heat-related emergency department encounters. Aggregate heat-related encounters, as a proportion of total emergency department encounters, increased by 170% from 2012 (4.3 per 10,000) to 2023 (11.6 per 10,000). Of all heat-related encounters, 418 (77%) had heat-specific diagnoses, and 131 (24%) had a diagnosis of rhabdomyolysis, a muscle-breakdown often caused by heat stress or prolonged exertion.

When examining the groups separately, most encounters with heat-specific diagnoses, like heat exhaustion and heat stroke, resulted in discharge from the emergency department without need for admission (96%). However, most of the rhabdomyolysis encounters resulted in hospital admission (63%). 
Children presenting with heat-specific concerns were younger and more likely to be Hispanic, use government-based insurance, and live in an area with a lower Child Opportunity Index score, according to the abstract.

 “As extreme summer temperatures become more frequent due to a changing climate, we’re seeing a rise in heat-related illnesses, particularly in vulnerable groups like children,” Dr. Merritt said.
  
Study author Taylor Merritt, MD, is scheduled to present the abstract, which is below, between 11:20 a.m.-11:25 a.m. at the Session (H3004) Council on Environmental Health and Climate Change. To request an interview with the authors, contact information is: UTSW Media Relations, [email protected]; Virginia Hock, [email protected], or Russell Rian, [email protected].

In addition, Dr. Merritt will be among highlighted abstract authors who will give brief presentations and be available for interviews during a press conference at noon-1:30 p.m. ET in the National Conference Press Room, W208 AB. During the meeting, you may reach AAP media relations staff at 407-685-5401.

Please note: Only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.  

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/

Abstract

Program Name: 2024 AAP National Conference-Abstracts

Submission Type: Council on Environmental Health and Climate Change

Abstract Title: Trends and outcomes of heat-related illnesses at a tertiary children’s hospital system in the southern United States, 2012-2023

Taylor Merritt

Dallas, TX, United States

As extreme summer temperatures become more frequent due to a changing climate, there is an increased risk of heat-related morbidity and mortality, particularly in vulnerable populations such as children. Heat-related illnesses represent a clinical spectrum of disorders ranging from heat cramps to heat stroke and may be complicated by end-organ injury such as rhabdomyolysis. Pediatric data on trends and outcomes of heat-related illness are lacking. This study aims to examine trends in heat-related illness over time and describe differences in patient characteristics and outcomes for children with "heat-specific" diagnoses compared to rhabdomyolysis.

We conducted a retrospective study at a pediatric health care system with two large children’s hospitals to identify Emergency Department (ED) encounters with a heat-related ED diagnosis during warm months (May through September) from 2012 to 2023. We included ED diagnoses corresponding to “excessive natural heat” (ICD-10 X30) and “effects of heat and light” (T67) (“heat-specific” diagnoses) and rhabdomyolysis (M62.82). We analyzed aggregate heat-related monthly ED encounters over time (Mann-Kendall) and association with maximum temperature (Pearson correlation). We described differences in “heat-specific” vs rhabdomyolysis encounters using Chi-square.

There were 542 heat-related ED encounters. Aggregate heat-related encounters, as a proportion of total ED encounters, increased by 170% from 2012 (4.3 per 10,000) to 2023 (11.6 per 10,000) (p=.01). Summer months with higher peak temperatures were associated with higher heat-related ED volume (r=0.66, p<.001) (Figure 1). Of all heat-related encounters, 418 (77%) had heat-specific diagnoses, and 131 (24%) had a rhabdomyolysis diagnosis. Compared to the rhabdomyolysis group, the heat-specific group was younger, more likely to be Hispanic, use government-based insurance, and live in an area with a lower Child Opportunity Index score. Most heat-specific encounters resulted in an ED discharge (96%), while most rhabdomyolysis encounters resulted in hospital admission (63%) (Table 1).

Heat-related illness ED volume is associated with higher temperature and is increasing over time. Rhabdomyolysis, compared to other heat-related illnesses, is associated with different patient characteristics, lower frequency, and higher severity. Given the rise in healthcare utilization from heat-related illness, it is essential for all pediatricians to understand the health implications of our changing climate.

Figure 1. Trends in Heat-Related Encounters Over Time and Association with Temperature During Warm Months (May-September), 2012-2023

Table 1. Demographics and Outcomes of Heat-Related Encounters, Stratified by Diagnosis Group