Intensive care unit admissions in Germany associated with atmospheric factors: a regional time-series analysis

Atmospheric exposures are associated with intensive care unit admissions across Germany from 2009–2023, with pressure-related variables significant in 29.3% of models and heat-related variables also linked.

• Why it matters: Climate-related atmospheric conditions may strain ICUs, but the disease- and region-specific patterns of these associations across Germany are not well characterized.
• What they did: Daily ICU admission time series from AOK insured persons (2009–2023) were analyzed by clustering Germany into 11 bioclimatic regions using principal component analysis, then fitting quasi-Poisson generalized additive models with optimal lags and multiple-testing control, stratified by age (<60, ≥60) and sex.
• The result: Heat-related predictors (tropical nights 18.3%, summer days 17.8%) and ozone among pollutants (15.6%) showed significant associations, more often in men and ≥60-year-olds, with mean model performance of 10% WED and best performance for NSTEMI in the East German Lowlands (49% WED).

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