Objective: We aim to compare the effect of ambient temperature on Emergency Department (ED) admissions among Parkinson’s Disease (PD) patients in extreme and regular temperatures between Boston, Massachusetts and San Antonio (SA), Texas.

Background: Boston and SA have low and high temperature extremes respectively. These are becoming more frequent and intense with climate change. We hypothesize that this affects PD patients, leading to increased ED admissions. We seek to provide insights into potential impacts of ambient temperature on this patient population. An observation of this relationship is lacking in the literature.

Method: We conducted a retrospective analysis using ED admissions of PD patients from two EDs – UTHealth SA and Saint Elizabeth’s Medical Center in Boston – between July 2020 and September 2023. Presenting symptoms were categorized to altered mental status (AMS), falls, urinary tract infection (UTI), syncope, other neurological, and other miscellaneous. Minimum and maximum daily temperatures were collected from the Weather Spark Database. Statistics utilized t-test and logistic regression for the association between temperature variation and diagnosis on presentation while controlling for potential confounders.

Results: 673 PD encounters were included. The male-female percentage was 46.1%-53.9% respectively, and 70.5% identified as White. Average age was 75.8 ± 10.3 years-old. Most common cause of ED admissions overall was falls and UTI in SA and other miscellaneous in Boston. Increased days with PD hospital admissions were seen during extreme cold (<32°F) in Boston and extreme heat (>90°F) in San Antonio. There were large spikes in presentation to the ED for falls (17.47%) and UTI (50%) for temperatures >90°F in SA. This pattern was not seen for Boston.

Conclusion: Temperature extremes influence the presentation of PD patients to ED in patterns that vary by geographical location. In SA, extreme heat was associated with an increase in ED visits due to falls and UTIs. In Boston, extreme cold was seen to increase ED visits for general causes. These findings highlight the need for patient-focused education on the risks of location-specific temperature changes, which can increase falls, infections, and ED visits. Larger studies are needed to better understand the impact of extreme temperatures amid climate change.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/seasonal-variations-in-emergency-department-admissions-among-parkinsons-disease-patients-a-north-south-comparative-analysis/