A heat-wave may be associated with increased mortality for vulnerable populations. Bouchama et al identified risk factors affecting mortality, which can help identify persons at risk.
Parameter
Increased Risk
Decreased Risk
mobility
confined to bed
highly mobile
travel outside of home
not done daily
frequent
activities of daily living
dependent
independent
social contact
limited
increased
comorbid disease
psychiatric, cardiac, respiratory
none
medications
psychotropic drugs
none
access to a means of cooling off
none
air conditioning, fan, extra bathing, able to go to a cool place
where:
• Most of the people who die during a heat wave are elderly. The vulnerable elderly have one or more of the risk factors.
• Air quality is often poor in a city during a heat wave, which can adversely affect a patient with respiratory disease.
• Hydration status and electrolyte balance would seem to be important factors.
The more adverse risk factors that are present, the greater the chances of a poor outcome.
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