The impact of extreme temperatures on emergency department visits: A systematic review of heatwaves, cold waves, and daily temperature variations

Abstract

Extreme temperature events increasingly challenge global public health systems, affecting both emergency department (ED) presentations and subsequent hospital admissions. Understanding these impacts on emergency healthcare utilization is critical for effective resource planning and public health preparedness. This systematic literature review, conducted following PRISMA guidelines, examines the influence of extreme temperature events on ED admissions. A comprehensive database search from 2012 to 2024 identified 42 relevant studies and two of them considered both heatwaves, coldwaves or temperature variation: 22 on heatwaves, 6 on cold waves, and 16 on temperature variations. Heatwaves are consistently associated with increased ED admissions for various health conditions, including orthopaedic trauma and exacerbations of chronic illnesses. At the same time, cold waves are linked primarily to respiratory and cardiovascular issues, often with delayed effects. Several studies indicate that older adults, those with pre-existing conditions, and socioeconomically disadvantaged populations may face disproportionately severe consequences during these events. Socio-demographic factors, including age, gender, socioeconomic status, and geographic location, significantly influence these outcomes. These findings highlight the differential impacts of extreme temperature events on ED utilization, emphasizing the importance of preparing EDs for post-event surges and advocating for coordinated emergency planning and targeted public health interventions to manage these challenges effectively. IMPLICATIONS FOR PUBLIC HEALTH: The findings of this study provide actionable insights for clinicians, academics, and policymakers to understand better the impact of extreme temperature events on emergency departments. This knowledge can guide the development of targeted public health strategies, enhance resource allocation, and strengthen healthcare systems to improve outcomes for vulnerable populations.

Keywords: Cold waves; Emergency department admission; Heatwaves; Systematic literature review; Temperature.