Key highlights in this article:
- Pediatric emergency department visits for heat-related illnesses increased by 170% between 2012 and 2023, with a strong correlation to rising summer temperatures.
- Children with heat-specific diagnoses tended to be younger, Hispanic, and more likely to have government-based insurance, while those with rhabdomyolysis had higher rates of hospital admissions.
- The growing number of heat-related pediatric cases highlights the need for pediatricians to be prepared to manage the impacts of climate change on children's health.
In research presented at the 2024 American Academy of Pediatrics National Conference & Exhibition, findings from a study found that emergency department (ED) visits among children for heat-related illnesses increased by 170% from 2012-2023. These findings were demonstrated at a pair of large children's hospitals.1
Data from the study abstract titled “Trends and Outcomes of Heat-Related Illnesses at a Tertiary Children’s Hospital System in the Southern United States, 2012-2023," revealed over 500 heat-related ED encounters.1
“As pediatricians, we see firsthand how excessive heat affects children’s health,” said Taylor Merritt, MD, author of the study. “The significant rise in heat-related illnesses over the past decade underscores a growing public health concern that warrants further attention and action."1
Background
With increasing extreme summer temperatures because of climate change, the risk of heat-related morbidity and mortality is rising, particularly in vulnerable populations such as children, according to the study authors. Heat-related illnesses encompass a spectrum of conditions, from mild heat cramps to severe heat stroke, and can be complicated by serious conditions such as rhabdomyolysis. However, pediatric data on the trends and outcomes of heat-related illnesses remain limited.2
This study aimed to analyze trends in heat-related illness over time and examine the differences in patient characteristics and outcomes between children with "heat-specific" diagnoses and those with rhabdomyolysis.2
Study details and findings
A retrospective study was conducted at a pediatric health care system, which included 2 large children's hospitals, to identify ED encounters with a heat-related diagnosis during the warm months (May through September) from 2012 to 2023. Heat-related diagnoses were categorized as either “excessive natural heat” (ICD-10 X30) or “effects of heat and light” (T67), collectively termed “heat-specific” diagnoses, or as rhabdomyolysis (M62.82).2
The analysis included aggregate heat-related ED encounters over time, utilizing the Mann-Kendall test to identify trends and Pearson correlation to assess associations with maximum temperatures. Differences between patients with heat-specific diagnoses and those with rhabdomyolysis were compared using the Chi-square test.2
A total of 542 heat-related ED encounters were identified over the study period. The rate of heat-related encounters, as a proportion of total ED visits, increased by 170% from 4.3 per 10,000 in 2012 to 11.6 per 10,000 in 2023 (P = .01). Higher peak summer temperatures were significantly correlated with higher volumes of heat-related ED visits (r = 0.66, P <.001). Of the total encounters, 418 (77%) were classified as heat-specific diagnoses, while 131 (24%) were associated with rhabdomyolysis.2
Compared to children with rhabdomyolysis, those with heat-specific diagnoses tended to be younger, more likely to be Hispanic, to have government-based insurance, and to live in areas with lower Child Opportunity Index scores. In terms of outcomes, 96% of the heat-specific cases were discharged from the ED, whereas 63% of rhabdomyolysis cases resulted in hospital admission.2
Conclusion
The volume of heat-related ED visits among pediatric patients is increasing over time and is strongly associated with higher summer temperatures. Rhabdomyolysis, though less common, tends to affect different patient populations and presents with higher severity, leading to more frequent hospital admissions. The rising healthcare utilization related to heat-related illnesses underscores the need for pediatricians to be aware of the health impacts of climate change and to be prepared for the management of heat-related conditions in children.2
References:
1. Children’s emergency department visits for heat-related illnesses increased 170% over past decade. The American Academy of Pediatrics. Press release. September 27, 2024. Accessed September 28, 2024.
2. Merritt T. Trends and outcomes of heat-related illnesses at a tertiary children’s hospital system in the southern United States, 2012-2023. Abstract. Presented at: 2024 American Academy of Pediatrics National Conference & Exhibition. September 27-October 1, 2024, in Orlando, Florida.
