How emergency departments might alert for pre-hospital heat-related excess mortality?
ABSTRACT: INTRODUCTION: A major issue raised by the public health consequences of a heat wave is the difficulty in detecting its direct consequences on patient outcome, particularly because of the delay in obtaining definitive mortality results. Since emergency department (ED) activity reflected the global increase of patients health problems during this period, the profile of patients referred to EDs might be a basis to detect an excess mortality in the catchments area. Our objective was to develop a real time surveillance model based on EDs data in order to detect as early as possible excessive heat related mortality. METHODS: A day-to-day composite indicator was built using simple and easily obtainable variables related to the patients referred to the EDs during the 2003 heat wave period. The design was a derivation and validation study based on a real time surveillance system of two EDs at Cochin and Hotel-Dieu hospitals, Paris, France. The participants were 99,976 adult patients r