The impact of a heat wave on mortality in the emergency department
Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the effects of the heat wave experienced in Izmir province of Turkey on mortality.During a 9-day period between 17th and 25th June 2016 (study period), air t...
Saved in:
Published in | Medicine (Baltimore) Vol. 97; no. 52; p. e13815 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Wolters Kluwer Health
01.12.2018
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the effects of the heat wave experienced in Izmir province of Turkey on mortality.During a 9-day period between 17th and 25th June 2016 (study period), air temperature values were higher than the seasonal norms in Izmir, Turkey. In this cross-sectional study, nontraumatic admissions and in-hospital mortality rates were compared this historical interval of the extreme heat wave with the same period of the previous year and the other 21 days of June 2016.The average air temperature between 17th and 25th June 2016, was higher than the average air temperature of the previous year's same period and the average air temperature from the other 21 days of June 2016 (27.8 ± 3.6 °C, (24.5 ± 1.9°C, 24.1 ± 2.1°C, respectively) (P <.01)During the study period, the mean number of ED visits and mortality rates were significantly higher than the previous year's same period (320 ± 30/day vs 269 ± 27/day, [P <.01], and 1.6% vs 0.7%, [P <.01]).Although the admission rate was similar between the study period and the other 21 days of June 2016 (320 ± 30/day vs 310 ± 32/ day, [P = .445]); in-hospital mortality rate was significantly higher during study period (1.6% vs 0.7%, [P <.01]).During the extreme heat waves, ED admissions and in-hospital mortality rates are increased. Precautions should be addressed for adaptation of people to extreme hot weather. |
---|---|
AbstractList | Abstract
Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the effects of the heat wave experienced in Izmir province of Turkey on mortality.
During a 9-day period between 17th and 25th June 2016 (study period), air temperature values were higher than the seasonal norms in Izmir, Turkey. In this cross-sectional study, nontraumatic admissions and in-hospital mortality rates were compared this historical interval of the extreme heat wave with the same period of the previous year and the other 21 days of June 2016.
The average air temperature between 17th and 25th June 2016, was higher than the average air temperature of the previous year's same period and the average air temperature from the other 21 days of June 2016 (27.8 ± 3.6 °C, (24.5 ± 1.9°C, 24.1 ± 2.1°C, respectively) (
P
<.01)
During the study period, the mean number of ED visits and mortality rates were significantly higher than the previous year's same period (320 ± 30/day vs 269 ± 27/day, [
P
<.01], and 1.6% vs 0.7%, [
P
<.01]).
Although the admission rate was similar between the study period and the other 21 days of June 2016 (320 ± 30/day vs 310 ± 32/ day, [
P
= .445]); in-hospital mortality rate was significantly higher during study period (1.6% vs 0.7%, [
P
<.01]).
During the extreme heat waves, ED admissions and in-hospital mortality rates are increased. Precautions should be addressed for adaptation of people to extreme hot weather. Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the effects of the heat wave experienced in Izmir province of Turkey on mortality.During a 9-day period between 17th and 25th June 2016 (study period), air temperature values were higher than the seasonal norms in Izmir, Turkey. In this cross-sectional study, nontraumatic admissions and in-hospital mortality rates were compared this historical interval of the extreme heat wave with the same period of the previous year and the other 21 days of June 2016.The average air temperature between 17th and 25th June 2016, was higher than the average air temperature of the previous year's same period and the average air temperature from the other 21 days of June 2016 (27.8 ± 3.6 °C, (24.5 ± 1.9°C, 24.1 ± 2.1°C, respectively) (P <.01)During the study period, the mean number of ED visits and mortality rates were significantly higher than the previous year's same period (320 ± 30/day vs 269 ± 27/day, [P <.01], and 1.6% vs 0.7%, [P <.01]).Although the admission rate was similar between the study period and the other 21 days of June 2016 (320 ± 30/day vs 310 ± 32/ day, [P = .445]); in-hospital mortality rate was significantly higher during study period (1.6% vs 0.7%, [P <.01]).During the extreme heat waves, ED admissions and in-hospital mortality rates are increased. Precautions should be addressed for adaptation of people to extreme hot weather. Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the effects of the heat wave experienced in Izmir province of Turkey on mortality. During a 9-day period between 17th and 25th June 2016 (study period), air temperature values were higher than the seasonal norms in Izmir, Turkey. In this cross-sectional study, nontraumatic admissions and in-hospital mortality rates were compared this historical interval of the extreme heat wave with the same period of the previous year and the other 21 days of June 2016. The average air temperature between 17th and 25th June 2016, was higher than the average air temperature of the previous year's same period and the average air temperature from the other 21 days of June 2016 (27.8 ± 3.6 °C, (24.5 ± 1.9°C, 24.1 ± 2.1°C, respectively) ( P <.01) During the study period, the mean number of ED visits and mortality rates were significantly higher than the previous year's same period (320 ± 30/day vs 269 ± 27/day, [ P <.01], and 1.6% vs 0.7%, [ P <.01]). Although the admission rate was similar between the study period and the other 21 days of June 2016 (320 ± 30/day vs 310 ± 32/ day, [ P = .445]); in-hospital mortality rate was significantly higher during study period (1.6% vs 0.7%, [ P <.01]). During the extreme heat waves, ED admissions and in-hospital mortality rates are increased. Precautions should be addressed for adaptation of people to extreme hot weather. |
Author | Oray, Deniz Oray, Nese Colak Bayram, Basak Aksay, Ersin Atilla, Ridvan |
AuthorAffiliation | a Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova b Izmir Medicalpark Hospital, Department of Emergency Medicine, Karsiyaka, İzmir, Turkey |
AuthorAffiliation_xml | – name: a Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova – name: b Izmir Medicalpark Hospital, Department of Emergency Medicine, Karsiyaka, İzmir, Turkey |
Author_xml | – sequence: 1 givenname: Nese Colak surname: Oray fullname: Oray, Nese Colak organization: Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova – sequence: 2 givenname: Deniz surname: Oray fullname: Oray, Deniz organization: Izmir Medicalpark Hospital, Department of Emergency Medicine, Karsiyaka, İzmir, Turkey – sequence: 3 givenname: Ersin surname: Aksay fullname: Aksay, Ersin organization: Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova – sequence: 4 givenname: Ridvan surname: Atilla fullname: Atilla, Ridvan organization: Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova – sequence: 5 givenname: Basak surname: Bayram fullname: Bayram, Basak organization: Dokuz Eylul University, Faculty of Medicine, Department of Emergency Medicine, Balcova |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30593174$$D View this record in MEDLINE/PubMed |
BookMark | eNpdkMtOwzAURC1URB_wBUjIP5Bix694gwQtL6kVm7K2HPemDWqcyDFF_XtSFcrjbmZxZ85IM0Q9X3tA6JKSMSVaXc-nY_JzlGVUnKABFUwmQkveQwNCUpEorXgfDdv2bW9SKT9DfUaEZlTxAbpbrAGXVWNdxHWBLV6DjfjDbgHXHld1iHZTxh0uPY6dEyoIK_Buh5fQ2BAr8PEcnRZ208LFl47Q68P9YvKUzF4enye3s8RxImKSE0ptrhhNBSk0z5jMU1dwqnnhhNN5XmRWZlJDmmfSSgkKnOQZaGKZJQLYCN0cuM17XsHSddXBbkwTysqGnaltaf5-fLk2q3prJKNcKtoB2AHgQt22AYpjlhKzn9TMp-b_pF3q6nftMfO9IfsEOXt0AA |
CitedBy_id | crossref_primary_10_1002_emp2_13098 crossref_primary_10_1097_MEJ_0000000000000975 crossref_primary_10_1017_npt_2021_6 crossref_primary_10_1016_j_joclim_2024_100310 crossref_primary_10_1002_joc_6877 crossref_primary_10_3390_ijerph192214781 crossref_primary_10_3390_atmos13122126 crossref_primary_10_1016_j_anzjph_2023_100115 crossref_primary_10_3390_ijerph16224348 crossref_primary_10_1097_MD_0000000000034299 crossref_primary_10_1111_risa_14294 crossref_primary_10_4330_wjc_v14_i3_152 crossref_primary_10_1159_000530747 crossref_primary_10_1111_1742_6723_14317 |
Cites_doi | 10.1016/j.scitotenv.2015.12.021 10.1289/ehp.1003198 10.1007/s10900-015-0080-7 10.1016/j.scitotenv.2016.04.042 10.1186/1476-069X-8-40 10.1186/1476-069X-14-11 10.1176/appi.ps.201100485 10.1016/j.envint.2011.11.011 10.1289/ehp.11594 10.1186/s12940-016-0109-0 10.1186/cc2404 10.1001/jama.2014.15715 10.1186/1472-6947-9-14 10.1177/1741826711402741 10.1136/emj.2005.028290 10.1016/j.ebiom.2016.02.034 10.1371/journal.pone.0155045 10.1186/s12873-015-0043-4 10.1017/S1049023X16000273 10.1136/jech-2013-202449 10.1371/journal.pone.0091831 10.1177/1010539512466428 10.1016/j.scitotenv.2010.02.009 10.1136/emj.2008.067934 |
ContentType | Journal Article |
Copyright | Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. 2018 |
Copyright_xml | – notice: Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. 2018 |
DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 5PM |
DOI | 10.1097/MD.0000000000013815 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef PubMed Central (Full Participant titles) |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef |
DatabaseTitleList | CrossRef MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1536-5964 |
ExternalDocumentID | 10_1097_MD_0000000000013815 30593174 |
Genre | Journal Article Observational Study |
GeographicLocations | Turkey |
GeographicLocations_xml | – name: Turkey |
GroupedDBID | --- .-D .3C .55 .GJ .XZ .Z2 01R 0R~ 1CY 354 40H 4Q1 4Q2 4Q3 53G 5GY 5RE 5VS 71W 77Y 7O~ 8L- AAAAV AAGIX AAHPQ AAIQE AAMOA AAQKA AARTV AASCR AAWTL AAXQO AAYEP ABASU ABBUW ABCQX ABDIG ABFRF ABOCM ABVCZ ABXVJ ABZAD ACDDN ACEWG ACGFO ACGFS ACILI ACLDA ACWDW ACWRI ACXJB ACXNZ ADFPA ADGGA ADHPY ADNKB ADPDF AE3 AE6 AEFWE AENEX AFDTB AFFNX AFUWQ AGOPY AHOMT AHQNM AHRYX AHVBC AIJEX AINUH AJIOK AJNWD AJNYG AJZMW AKULP ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AWKKM BQLVK BS7 CGR CS3 CUY CVF DIWNM DU5 E.X EBS ECM EEVPB EIF EJD ERAAH EX3 F2K F2L F2M F2N F5P FCALG FD6 FIJ FL- FW0 GNXGY GQDEL GROUPED_DOAJ H0~ HLJTE HYE HZ~ H~9 IKREB IKYAY IN~ IPNFZ JF9 JG8 JK3 JK8 K8S KD2 KMI KQ8 L-C N4W N9A NPM N~7 N~B N~M O9- OAG OAH OB2 OCUKA ODA OHH OK1 OL1 OLB OLG OLH OLU OLV OLW OLY OLZ OPUJH ORVUJ OUVQU OVD OVDNE OVEED OVIDH OVLEI OWU OWV OWW OWZ OXXIT P-K P2P R58 RIG RLZ RPM RXW S4R S4S T8P TAF TEORI TSPGW UNMZH V2I VVN W3M WOQ WOW X3V X3W X7M XXN XYM YFH YOC ZFV ZGI ZXP ZY1 AAYXX CITATION 5PM |
ID | FETCH-LOGICAL-c405t-b011ab731250f94836b2cf4194fc5c9bbf8a6869e2b86a66e7ec648e90a3a05e3 |
IEDL.DBID | RPM |
ISSN | 0025-7974 |
IngestDate | Tue Sep 17 21:16:27 EDT 2024 Fri Aug 23 01:20:03 EDT 2024 Wed Oct 16 00:44:43 EDT 2024 |
IsDoiOpenAccess | true |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 52 |
Language | English |
License | This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c405t-b011ab731250f94836b2cf4194fc5c9bbf8a6869e2b86a66e7ec648e90a3a05e3 |
OpenAccessLink | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314671/ |
PMID | 30593174 |
ParticipantIDs | pubmedcentral_primary_oai_pubmedcentral_nih_gov_6314671 crossref_primary_10_1097_MD_0000000000013815 pubmed_primary_30593174 |
PublicationCentury | 2000 |
PublicationDate | 2018-12-01 |
PublicationDateYYYYMMDD | 2018-12-01 |
PublicationDate_xml | – month: 12 year: 2018 text: 2018-12-01 day: 01 |
PublicationDecade | 2010 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | Medicine (Baltimore) |
PublicationTitleAlternate | Medicine (Baltimore) |
PublicationYear | 2018 |
Publisher | Wolters Kluwer Health |
Publisher_xml | – name: Wolters Kluwer Health |
References | Davido (R25-20230914) 2006; 23 Oberlin (R6-20230914) 2010; 27 Ghumman (R8-20230914) 2016; 31 Chien (R14-20230914) 2016; 562 Calkins (R10-20230914) 2016; 15 Vida (R21-20230914) 2012; 63 Basu (R2-20230914) 2009; 8 Zhang (R9-20230914) 2015; 14 Abrignani (R20-20230914) 2012; 19 Dhainaut (R24-20230914) 2004; 8 Hajat (R4-20230914) 2014; 68 Bunker (R13-20230914) 2016; 6 Azhar (R15-20230914) 2014; 9 Bobb (R17-20230914) 2014; 312 Knowlton (R1-20230914) 2009; 117 Huang (R3-20230914) 2010; 408 Williams (R5-20230914) 2012; 40 Fuhrmann (R11-20230914) 2016; 41 Dalip (R12-20230914) 2015; 27 Bishop-Williams (R7-20230914) 2015; 15 Josseran (R26-20230914) 2009; 9 Ho (R22-20230914) 2016; 544 Ye (R23-20230914) 2012; 120 Oudin Åström (R16-20230914) 2016; 11 |
References_xml | – volume: 544 start-page: 929 year: 2016 ident: R22-20230914 article-title: A comparison of urban heat islands mapped using skin temperature, air temperature, and apparent temperature (Humidex), for the greater Vancouver area publication-title: Sci Total Environ doi: 10.1016/j.scitotenv.2015.12.021 contributor: fullname: Ho – volume: 120 start-page: 19 year: 2012 ident: R23-20230914 article-title: Ambient temperature and morbidity: a review of epidemiological evidence publication-title: Environ Health Perspect doi: 10.1289/ehp.1003198 contributor: fullname: Ye – volume: 41 start-page: 146 year: 2016 ident: R11-20230914 article-title: Impact of extreme heat events on emergency department visits in North Carolina (2007–2011) publication-title: J Community Health doi: 10.1007/s10900-015-0080-7 contributor: fullname: Fuhrmann – volume: 562 start-page: 845 year: 2016 ident: R14-20230914 article-title: Spatiotemporal analysis of heat and heat wave effects on elderly mortality in Texas, 2006–2011 publication-title: Sci Total Environ doi: 10.1016/j.scitotenv.2016.04.042 contributor: fullname: Chien – volume: 8 start-page: 40 year: 2009 ident: R2-20230914 article-title: High ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008 publication-title: Environ Health doi: 10.1186/1476-069X-8-40 contributor: fullname: Basu – volume: 14 start-page: 11 year: 2015 ident: R9-20230914 article-title: Impact of the 2011 heat wave on mortality and emergency department visits in Houston, Texas publication-title: Environ Health doi: 10.1186/1476-069X-14-11 contributor: fullname: Zhang – volume: 63 start-page: 1150 year: 2012 ident: R21-20230914 article-title: Relationship between ambient temperature and humidity and visits to mental health emergency departments in Québec publication-title: Psychiatr Serv doi: 10.1176/appi.ps.201100485 contributor: fullname: Vida – volume: 40 start-page: 33 year: 2012 ident: R5-20230914 article-title: The impact of summer temperatures and heatwaves on mortality and morbidity in Perth, Australia 1994-2008 publication-title: Environ Int doi: 10.1016/j.envint.2011.11.011 contributor: fullname: Williams – volume: 117 start-page: 61 year: 2009 ident: R1-20230914 article-title: The 2006 California heat wave: impacts on hospitalizations and emergency department visits publication-title: Environ Health Perspect doi: 10.1289/ehp.11594 contributor: fullname: Knowlton – volume: 15 start-page: 13 year: 2016 ident: R10-20230914 article-title: Impacts of extreme heat on emergency medical service calls in King County, Washington, 2007-2012: relative risk and time series analyses of basic and advanced life support publication-title: Environ Health doi: 10.1186/s12940-016-0109-0 contributor: fullname: Calkins – volume: 8 start-page: 1 year: 2004 ident: R24-20230914 article-title: Unprecedented heat-related deaths during the 2003 heat wave in Paris: consequences on emergency departments publication-title: Crit Care doi: 10.1186/cc2404 contributor: fullname: Dhainaut – volume: 312 start-page: 2659 year: 2014 ident: R17-20230914 article-title: Cause-specific risk of hospital admission related to extreme heat in older adults publication-title: JAMA doi: 10.1001/jama.2014.15715 contributor: fullname: Bobb – volume: 9 start-page: 14 year: 2009 ident: R26-20230914 article-title: Syndromic surveillance and heat wave morbidity: pilot study based on emergency departmentsin France publication-title: BMC Med Inform Decis Mak doi: 10.1186/1472-6947-9-14 contributor: fullname: Josseran – volume: 19 start-page: 342 year: 2012 ident: R20-20230914 article-title: Effects of ambient temperature, humidity, and other meteorological variables on hospital admissions for angina pectoris publication-title: Eur J Prev Cardiol doi: 10.1177/1741826711402741 contributor: fullname: Abrignani – volume: 23 start-page: 515 year: 2006 ident: R25-20230914 article-title: Risk factors for heat related death during the August 2003 heat wave in Paris, France, in patients evaluated at the emergency department of the Hôpital Européen Georges Pompidou publication-title: Emerg Med J doi: 10.1136/emj.2005.028290 contributor: fullname: Davido – volume: 6 start-page: 258 year: 2016 ident: R13-20230914 article-title: Effects of air temperature on climate-sensitive mortality and morbidity outcomes in the elderly; a systematic review and meta-analysis of epidemiological evidence publication-title: EBioMedicine doi: 10.1016/j.ebiom.2016.02.034 contributor: fullname: Bunker – volume: 11 start-page: e0155045 year: 2016 ident: R16-20230914 article-title: High summer temperatures and mortality in Estonia publication-title: PLoS One doi: 10.1371/journal.pone.0155045 contributor: fullname: Oudin Åström – volume: 15 start-page: 17 year: 2015 ident: R7-20230914 article-title: A spatial analysis of heat stress related emergency room visits in rural Southern Ontario during heat waves publication-title: BMC Emerg Med doi: 10.1186/s12873-015-0043-4 contributor: fullname: Bishop-Williams – volume: 31 start-page: 263 year: 2016 ident: R8-20230914 article-title: Characterizing the impact of extreme heat on mortality, Karachi, Pakistan, June 2015 publication-title: Prehosp Disaster Med doi: 10.1017/S1049023X16000273 contributor: fullname: Ghumman – volume: 68 start-page: 641 year: 2014 ident: R4-20230914 article-title: Climate change effects on human health: projections of temperature-related mortality for the UK during the 2020s, 2050s and 2080s publication-title: J Epidemiol Community Health doi: 10.1136/jech-2013-202449 contributor: fullname: Hajat – volume: 9 start-page: e91831 year: 2014 ident: R15-20230914 article-title: Ahmedabad heat climate study group heat-related mortality in India: excess all-cause mortality associated with the 2010 Ahmedabad heatwave publication-title: PLoS One doi: 10.1371/journal.pone.0091831 contributor: fullname: Azhar – volume: 27 start-page: N1837 year: 2015 ident: R12-20230914 article-title: Can the elderly handle the heat? A retrospective case-control study of the impact of heat waves on older patients attending an inner city Australian emergency department publication-title: Asia Pac J Public Health doi: 10.1177/1010539512466428 contributor: fullname: Dalip – volume: 408 start-page: 2418 year: 2010 ident: R3-20230914 article-title: The impact of the 2003 heat wave on mortality in Shanghai, China publication-title: Sci Total Environ doi: 10.1016/j.scitotenv.2010.02.009 contributor: fullname: Huang – volume: 27 start-page: 297 year: 2010 ident: R6-20230914 article-title: Heat-related illnesses during the 2003 heat wave in an emergency service publication-title: Emerg Med J doi: 10.1136/emj.2008.067934 contributor: fullname: Oberlin |
SSID | ssj0013724 |
Score | 2.3992996 |
Snippet | Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the effects of... Abstract Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the... |
SourceID | pubmedcentral crossref pubmed |
SourceType | Open Access Repository Aggregation Database Index Database |
StartPage | e13815 |
SubjectTerms | Adolescent Adult Aged Aged, 80 and over Cross-Sectional Studies Emergency Service, Hospital - statistics & numerical data Extreme Heat - adverse effects Female Hospital Mortality Humans Male Middle Aged Observational Study Tertiary Care Centers - statistics & numerical data Turkey Young Adult |
Title | The impact of a heat wave on mortality in the emergency department |
URI | https://www.ncbi.nlm.nih.gov/pubmed/30593174 https://pubmed.ncbi.nlm.nih.gov/PMC6314671 |
Volume | 97 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3JTsMwEB2VIiEuiJ2yVD5wJM1ix3aO0EUVUoADRb1VdjIRlWhaVQV-H2dxRDmSa-womrE9z5o3bwBuBWZIhQwdyhAdFijmaMYDhyuq0ZyOqSx1C-InPp6wx2k4bUFoa2FK0n6i5738Y9HL5-8lt3K1SFzLE3Nf4j6nxf723R3YMQvUXtFt6kAErOnTatCylRqKhBsPKrnC6vFNsCoa19Ciq50v2FZkasLRNlXyV-wZHcJBDRrJffVzR9DC_Bj24jotfgIPxtmkqncky4woUpyw5Ft9IVnmZFEibIO2yTwnBu8RtCWXJDXBaF3yzE9hMhq-9sdO3RzBSQzG2jjabEylBTUAxcsiJinXQZIxP2JZEiaR1plUXPIIAy254hwFJpxJjDxFlRciPYN2vszxAojBHD5GSjIqQ5ZyT6FOIy20-RomVPMO3FnDzFaVBsbM5q7jweyvSTtwXtmsGWwt3AGxZc1mQKFxvf3GuL7Uuq5dffnvmVewbzCOrBgo19DerD_xxuCIje6W9-8u7D6_DYeDbrmKfgA_kMbh |
link.rule.ids | 230,315,730,783,787,867,888,27937,27938,53805,53807 |
linkProvider | National Library of Medicine |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3JTsMwEB2xSMCFfSmrDxxJm8SO7RyhUBVoKg4t4lbZ7kRU0LRCBSS-HiepK8oNcrUTJTO250Xz5g3AucAUqZCRRxmix0LFPM146HFFNdrTsS8L3YKkzZtddvcUPS1A5GphCtK-0YNq9jqsZoPngls5Hpqa44nVHpI6p_n-DmqLsGz3qx-5n3SXPBAhm3VqtXjZiQ3FopZcl4KF5RXYcJW3rqF5X7tAsLnYNAtI82TJH9GnsQGP7r1L0slL9X2iq-brl6Tjnz9sE9aneJRclsNbsIDZNqwk04z7DlzZdUTKUkoySoki-eFNPtUHklFGhgV4t0CeDDJioSRBV81J-jbOvRUU9l3oNm469aY37bvgGQvfJp62e15pQS328dOYScp1aFIWxCw1kYm1TqXikscYaskV5yjQcCYx9hVVfoR0D5ayUYYHQCycCTBWklEZsT73Fep-rIW2T0NDNa_AhbN4b1zKa_RcWjy57v32VQX2S2fMJjvXVUDMuWk2IZfPnh-xxi9ktKfGPvz3nWew2uwkrV7rtn1_BGsWSsmS6HIMS5O3dzyxcGWiT4vF-Q30UuZJ |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3JTsMwEB1BkRAX9qWsPnAkTRM7tnMESsUWxIFKFZfKdiaigqZV1YLE1-MkdUU5kqvHVuKxPS-a5zcA5wIzpEJGHmWIHgsV8zTjoccV1WhPx1SWugXJE7_tsPtu1P1V6qsk7Rvdb-Qfg0befyu5laOB8R1PzH9Orjkt9nfgj9LMX4aVqBBNdz_qLoEgQjav1moxsxMcioWftCrRwuoJbMgqytfQorZdINhCfJoHpUXC5K8I1N6AV_fuFfHkvTGd6Ib5_iPr-K-P24T1GS4ll5XJFixhvg2rySzzvgNXdj2R6kolGWZEkeIQJ1_qE8kwJ4MSxFtAT_o5sZCSoLvVSVIb78YllX0XOu2bl-tbb1Z_wTMWxk08bfe-0oJaDNTMYiYp16HJWBCzzEQm1jqTikseY6glV5yjQMOZxLipqGpGSPeglg9zPABiYU2AsZKMyoilvKlQp7EW2o6Ghmpehws3671RJbPRc-nxpNX766867FcOmRs799VBLLhqblDIaC-2WAeUctqzCT_8d88zWH1utXuPd08PR7BmEZWs-C7HUJuMp3hiUctEn5br8wdYr-jJ |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+impact+of+a+heat+wave+on+mortality+in+the+emergency+department&rft.jtitle=Medicine+%28Baltimore%29&rft.au=Oray%2C+Nese+Colak&rft.au=Oray%2C+Deniz&rft.au=Aksay%2C+Ersin&rft.au=Atilla%2C+Ridvan&rft.date=2018-12-01&rft.pub=Wolters+Kluwer+Health&rft.issn=0025-7974&rft.eissn=1536-5964&rft.volume=97&rft.issue=52&rft_id=info:doi/10.1097%2FMD.0000000000013815&rft_id=info%3Apmid%2F30593174&rft.externalDBID=PMC6314671 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0025-7974&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0025-7974&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0025-7974&client=summon |