Temperature change between neighboring days and hospital admissions in China

The short-term temperature fluctuation caused by global climate change is one of the risk factors affecting public health. Exploring the association between temperature fluctuation and diseases, which has received relatively limited research attention, can contribute to enhancing awareness of health risks and taking timely measures for health risk alert and management. Therefore, this study aims to investigate the relationship between temperature change between neighboring days (TCN) and hospitalizations, identify diseases sensitive to extreme TCN, and evaluate the related disease burden. We collected meteorological and hospitalization data from 2014 to 2019 in 23 sites of China to explore the impact of TCN on hospitalizations. We first quantified site -specific associations between TCN and hospitalizations and then conducted metaanalysis to pool the results, to assess the relative risk of extreme TCN for susceptible diseases, and to estimate the related disease burden attributed to TCN. Stratified analyses were undertaken by age, sex, and disease type. Results showed that all -cause hospital admission was significantly linked to TCN. A negative TCN (below -1.9 degrees C) in the cool season and a positive TCN (above 1.0 degrees C) in the warm season increased the risk of hospitalization. People aged 15-64 years, men, and patients with musculoskeletal system or connective tissue diseases were more sensitive to extremely negative TCN during the cool season. People aged over 65 years, men, and patients with respiratory diseases were more sensitive to extremely positive TCN during the warm season. The attributable fraction to all -cause hospitalization from negative TCN in the cool season was 2.05% (95% CI: -0.90%, 4.53%) and from positive TCN in the warm season was 5.79% (95% CI: 2.98%, 8.31%). Circulatory diseases in the cool season and respiratory diseases in the warm season had the highest disease burden. Our findings indicate that awareness of TCN and its health risks should be promoted and evidence -informed policies are needed to reduce the risk of TCN.