Abstract
Background and Aims: A robust climate-health projection model has the potential to improve health care resource allocation. We aim to explore the relationship between Australian intensive care unit (ICU) demand and various measures of the long-lived large-scale climate and to develop a future nationwide climate-health projection model. Methods: We investigated patients admitted to ICUs in Australia between January 2003 and December 2019 who were exposed to long-lived large-scale combined climatic measures of temperature and humidity. We analysed the projected demand for respiratory-related ICU average length of stay (in days) per capita (ICUD/C) with four historical and one future projection dataset. These datasets included: i) Australian and New Zealand Intensive Care Society adult patient database, ii) Socioeconomic Data and Applications Center gridded global historical population, iii) Australian Bureau of Statistics national historical population, iv) Japanese 55-year Reanalysis historical climate (JRA55), and v) the fifth Coupled Model Inter-comparison Project future climate projections. Results: 148,638 patients with respiratory issues required intensive care between 2003 and 2019. The annual growth in the population density-weighted wet-bulb-globe temperature—a combined measure of temperature and humidity—is strongly correlated with the annual per capita growth ICUD/C for respiratory-related conditions (r=0.771; p<0.001). This relationship was applied to develop a model projecting future respiratory-related ICU demand with three possible future Representative Concentration Pathways (RCP). RCP2.6 (lowest carbon emission climate scenario) showed only a 33.4% increase in Australian ICUD/C demand by 2090, while the RCP8.5 (highest carbon emission climate scenario) demonstrated almost two-fold higher demand (66.1%) than RCP2.6 by 2090. Conclusions: The annual growth in population density-weighted wet-bulb-globe temperature correlates with the annual growth in Australian ICUD/C for respiratory-related conditions. A model based on possible future climate scenarios can be developed to predict changes in ICU demand in response to CO2 changes over the coming decades.
| Original language | English |
|---|---|
| Pages (from-to) | 95-104 |
| Number of pages | 100 |
| Journal | Heart Lung and Circulation |
| Volume | 32 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2023 |
Keywords
- Climate change
- Critical care services
- Intensive care units
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In: Heart Lung and Circulation, Vol. 32, No. 1, 01.2023, p. 95-104.
Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Projecting future climate impact on national Australian respiratory-related intensive care unit demand
AU - Poon, Eric K.W.
AU - Kitsios, Vassili
AU - Pilcher, David
AU - Bellomo, Rinaldo
AU - Raman, Jai
N1 - Funding Information: The authors and the Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resources Evaluation (ANZICS CORE) management committee would like to thank clinicians, data collectors and researchers at the following Australian contributing sites: Albury Base Hospital ICU, Vic; Alfred Hospital ICU, Vic; Alice Springs Hospital ICU, NT; Austin Hospital ICU, Vic; Ballarat Health Services ICU, Vic; Bankstown-Lidcombe Hospital ICU, NSW; Bendigo Health Care Group ICU, Vic; Blacktown Hospital ICU, NSW; Box Hill Hospital ICU, Vic; Bundaberg Base Hospital ICU, Qld; Caboolture Hospital ICU, Qld; Cairns Hospital ICU, Qld; Calvary Hospital (Canberra) ICU, ACT; Calvary Mater Newcastle ICU, NSW; Calvary Wakefield Hospital (Adelaide) ICU, SA; Canberra Hospital ICU, ACT; Coffs Harbour Health Campus ICU, NSW; Concord Hospital (Sydney) ICU, NSW; Dandenong Hospital ICU, Vic; Epworth Freemasons Hospital ICU, Vic; Flinders Medical Centre ICU, SA; Frankston Hospital ICU. Vic; Gold Coast University Hospital ICU, Qld; Gosford Hospital ICU, NSW; Goulburn Valley Health ICU, Vic; Grafton Base Hospital ICU, NSW; Hornsby Ku-ring-gai Hospital ICU, NSW; Ipswich Hospital ICU, Qld; John Flynn Private Hospital ICU, Qld; John Hunter Hospital ICU, NSW; Knox Private Hospital ICU, Vic; Latrobe Regional Hospital ICU, Vic; Launceston General Hospital ICU, Tas; Lismore Base Hospital ICU, NSW; Liverpool Hospital ICU, NSW; Logan Hospital ICU, Qld; Maroondah Hospital ICU, Vic; Mater Adults Hospital (Brisbane) ICU, Qld; Mater Health Services North Queensland ICU, Qld; Mater Private Hospital (Brisbane) ICU, Qld; Melbourne Private Hospital ICU, Vic; Monash Medical Centre-Clayton Campus ICU, Vic; Mount Hospital ICU, WA; Nepean Hospital ICU, NSW; North Shore Private Hospital ICU, NSW; Northeast Health Wangaratta ICU, Vic; Orange Base Hospital ICU, NSW; Prince of Wales Private Hospital (Sydney) ICU, NSW; Queen Elizabeth II Jubilee Hospital ICU, Qld; Redcliffe Hospital ICU, Qld; Rockhampton Hospital ICU, Qld; Royal Adelaide Hospital ICU, SA; Royal Brisbane and Women's Hospital ICU, Qld; Royal Darwin Hospital ICU, NT; Royal Hobart Hospital ICU, Tas; Royal Melbourne Hospital ICU, Vic; Royal North Shore Hospital ICU, NSW; Royal Perth Hospital ICU, WA; Royal Prince Alfred Hospital ICU, NSW; Shoalhaven Hospital ICU, NSW; Sir Charles Gairdner Hospital ICU, WA; St Andrew's Hospital (Adelaide) ICU, SA; St Andrew's War Memorial Hospital ICU, Qld; St George Hospital (Sydney) ICU, NSW; St George Private Hospital (Sydney) ICU, NSW; St Vincent's Hospital (Melbourne) ICU, Vic; St Vincent's Hospital (Sydney) ICU, NSW; Sutherland Hospital & Community Health Services ICU, NSW; Sydney Adventist Hospital ICU, NSW; Tamworth Base Hospital ICU, NSW; The Northern Hospital ICU, Vic; The Prince Charles Hospital ICU, Qld; The Townsville Hospital ICU, Qld; The Valley Private Hospital ICU, Vic; The Wesley Hospital ICU, Qld; Toowoomba Hospital ICU, Qld; Tweed Heads District Hospital ICU, NSW; University Hospital Geelong ICU, Vic; Westmead Hospital ICU, NSW; Westmead Private Hospital ICU, NSW; and Wollongong Hospital ICU. NSW. V. Kitsios is funded by the CSIRO Artificial Intelligence for Missions program. The JRA55 and CMIP5 data are freely publicly available from https://jra.kishou.go.jp/JRA-55/index_en.html and https://pcmdi.llnl.gov/mips/cmip5/data-portal.html, respectively. Requests for access to ICU data (subject to restrictions due to personal health care information) can be made to ANZICS CORE. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This research was reviewed and approved as a low-risk study by the Human Research and Ethics Committee of The Alfred Hospital, Melbourne, Australia (HREC number 631-20). The need for informed consent was waived as this study used deidentified data already collected by the ANZICS Clinical Quality Registry. Funding Information: The authors and the Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resources Evaluation (ANZICS CORE) management committee would like to thank clinicians, data collectors and researchers at the following Australian contributing sites: Albury Base Hospital ICU, Vic; Alfred Hospital ICU, Vic; Alice Springs Hospital ICU, NT; Austin Hospital ICU, Vic; Ballarat Health Services ICU, Vic; Bankstown-Lidcombe Hospital ICU, NSW; Bendigo Health Care Group ICU, Vic; Blacktown Hospital ICU, NSW; Box Hill Hospital ICU, Vic; Bundaberg Base Hospital ICU, Qld; Caboolture Hospital ICU, Qld; Cairns Hospital ICU, Qld; Calvary Hospital (Canberra) ICU, ACT; Calvary Mater Newcastle ICU, NSW; Calvary Wakefield Hospital (Adelaide) ICU, SA; Canberra Hospital ICU, ACT; Coffs Harbour Health Campus ICU, NSW; Concord Hospital (Sydney) ICU, NSW; Dandenong Hospital ICU, Vic; Epworth Freemasons Hospital ICU, Vic; Flinders Medical Centre ICU, SA; Frankston Hospital ICU. Vic; Gold Coast University Hospital ICU, Qld; Gosford Hospital ICU, NSW; Goulburn Valley Health ICU, Vic; Grafton Base Hospital ICU, NSW; Hornsby Ku-ring-gai Hospital ICU, NSW; Ipswich Hospital ICU, Qld; John Flynn Private Hospital ICU, Qld; John Hunter Hospital ICU, NSW; Knox Private Hospital ICU, Vic; Latrobe Regional Hospital ICU, Vic; Launceston General Hospital ICU, Tas; Lismore Base Hospital ICU, NSW; Liverpool Hospital ICU, NSW; Logan Hospital ICU, Qld; Maroondah Hospital ICU, Vic; Mater Adults Hospital (Brisbane) ICU, Qld; Mater Health Services North Queensland ICU, Qld; Mater Private Hospital (Brisbane) ICU, Qld; Melbourne Private Hospital ICU, Vic; Monash Medical Centre-Clayton Campus ICU, Vic; Mount Hospital ICU, WA; Nepean Hospital ICU, NSW; North Shore Private Hospital ICU, NSW; Northeast Health Wangaratta ICU, Vic; Orange Base Hospital ICU, NSW; Prince of Wales Private Hospital (Sydney) ICU, NSW; Queen Elizabeth II Jubilee Hospital ICU, Qld; Redcliffe Hospital ICU, Qld; Rockhampton Hospital ICU, Qld; Royal Adelaide Hospital ICU, SA; Royal Brisbane and Women’s Hospital ICU, Qld; Royal Darwin Hospital ICU, NT; Royal Hobart Hospital ICU, Tas; Royal Melbourne Hospital ICU, Vic; Royal North Shore Hospital ICU, NSW; Royal Perth Hospital ICU, WA; Royal Prince Alfred Hospital ICU, NSW; Shoalhaven Hospital ICU, NSW; Sir Charles Gairdner Hospital ICU, WA; St Andrew’s Hospital (Adelaide) ICU, SA; St Andrew’s War Memorial Hospital ICU, Qld; St George Hospital (Sydney) ICU, NSW; St George Private Hospital (Sydney) ICU, NSW; St Vincent’s Hospital (Melbourne) ICU, Vic; St Vincent’s Hospital (Sydney) ICU, NSW; Sutherland Hospital & Community Health Services ICU, NSW; Sydney Adventist Hospital ICU, NSW; Tamworth Base Hospital ICU, NSW; The Northern Hospital ICU, Vic; The Prince Charles Hospital ICU, Qld; The Townsville Hospital ICU, Qld; The Valley Private Hospital ICU, Vic; The Wesley Hospital ICU, Qld; Toowoomba Hospital ICU, Qld; Tweed Heads District Hospital ICU, NSW; University Hospital Geelong ICU, Vic; Westmead Hospital ICU, NSW; Westmead Private Hospital ICU, NSW; and Wollongong Hospital ICU. NSW. V. Kitsios is funded by the CSIRO Artificial Intelligence for Missions program. Publisher Copyright: © 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)
PY - 2023/1
Y1 - 2023/1
N2 - Background and Aims: A robust climate-health projection model has the potential to improve health care resource allocation. We aim to explore the relationship between Australian intensive care unit (ICU) demand and various measures of the long-lived large-scale climate and to develop a future nationwide climate-health projection model. Methods: We investigated patients admitted to ICUs in Australia between January 2003 and December 2019 who were exposed to long-lived large-scale combined climatic measures of temperature and humidity. We analysed the projected demand for respiratory-related ICU average length of stay (in days) per capita (ICUD/C) with four historical and one future projection dataset. These datasets included: i) Australian and New Zealand Intensive Care Society adult patient database, ii) Socioeconomic Data and Applications Center gridded global historical population, iii) Australian Bureau of Statistics national historical population, iv) Japanese 55-year Reanalysis historical climate (JRA55), and v) the fifth Coupled Model Inter-comparison Project future climate projections. Results: 148,638 patients with respiratory issues required intensive care between 2003 and 2019. The annual growth in the population density-weighted wet-bulb-globe temperature—a combined measure of temperature and humidity—is strongly correlated with the annual per capita growth ICUD/C for respiratory-related conditions (r=0.771; p<0.001). This relationship was applied to develop a model projecting future respiratory-related ICU demand with three possible future Representative Concentration Pathways (RCP). RCP2.6 (lowest carbon emission climate scenario) showed only a 33.4% increase in Australian ICUD/C demand by 2090, while the RCP8.5 (highest carbon emission climate scenario) demonstrated almost two-fold higher demand (66.1%) than RCP2.6 by 2090. Conclusions: The annual growth in population density-weighted wet-bulb-globe temperature correlates with the annual growth in Australian ICUD/C for respiratory-related conditions. A model based on possible future climate scenarios can be developed to predict changes in ICU demand in response to CO2 changes over the coming decades.
AB - Background and Aims: A robust climate-health projection model has the potential to improve health care resource allocation. We aim to explore the relationship between Australian intensive care unit (ICU) demand and various measures of the long-lived large-scale climate and to develop a future nationwide climate-health projection model. Methods: We investigated patients admitted to ICUs in Australia between January 2003 and December 2019 who were exposed to long-lived large-scale combined climatic measures of temperature and humidity. We analysed the projected demand for respiratory-related ICU average length of stay (in days) per capita (ICUD/C) with four historical and one future projection dataset. These datasets included: i) Australian and New Zealand Intensive Care Society adult patient database, ii) Socioeconomic Data and Applications Center gridded global historical population, iii) Australian Bureau of Statistics national historical population, iv) Japanese 55-year Reanalysis historical climate (JRA55), and v) the fifth Coupled Model Inter-comparison Project future climate projections. Results: 148,638 patients with respiratory issues required intensive care between 2003 and 2019. The annual growth in the population density-weighted wet-bulb-globe temperature—a combined measure of temperature and humidity—is strongly correlated with the annual per capita growth ICUD/C for respiratory-related conditions (r=0.771; p<0.001). This relationship was applied to develop a model projecting future respiratory-related ICU demand with three possible future Representative Concentration Pathways (RCP). RCP2.6 (lowest carbon emission climate scenario) showed only a 33.4% increase in Australian ICUD/C demand by 2090, while the RCP8.5 (highest carbon emission climate scenario) demonstrated almost two-fold higher demand (66.1%) than RCP2.6 by 2090. Conclusions: The annual growth in population density-weighted wet-bulb-globe temperature correlates with the annual growth in Australian ICUD/C for respiratory-related conditions. A model based on possible future climate scenarios can be developed to predict changes in ICU demand in response to CO2 changes over the coming decades.
KW - Climate change
KW - Critical care services
KW - Intensive care units
UR - http://www.scopus.com/inward/record.url?scp=85145997181&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2022.12.001
DO - 10.1016/j.hlc.2022.12.001
M3 - Article
C2 - 36604222
AN - SCOPUS:85145997181
SN - 1443-9506
VL - 32
SP - 95
EP - 104
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 1
ER -