Heatwaves are among the fastest-growing climate-related threats to human health, increasing in frequency, intensity and duration with climate change. Older adults are disproportionately affected, reflecting intersecting physiological, social and economic vulnerabilities. Beyond mortality, heatwaves drive substantial but often under-recognised morbidity, including emergency visits and hospitalisations for cardiovascular, respiratory, renal and metabolic conditions. Health administrative data provide valuable opportunities to improve understanding of these phenomena and for the quantification of their impacts. However, comparability is limited by heterogeneity in case definitions, that is, the criteria used to determine which health events are counted as cases: some studies only clinically diagnosed heat illness, while others also capture outcomes plausibly triggered or exacerbated by heat. It is further constrained by differences in International Classification of Diseases (ICD) versions, national adaptations, coding practices and adoption timelines across countries. No synthesis has yet mapped these heterogeneous approaches for older adults, despite their over-representation among those most affected by heat-health risks. This heterogeneity limits the ability to capture the true burden of disease and to inform adaptation planning.

We will conduct a scoping review to map how heat-related diagnoses among older adults are identified and measured in health administrative data. The review will follow the initial methodological framework of Arksey and O’Malley refined by Levac et al and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The search strategy will be developed with a public health librarian and applied to MEDLINE (Ovid), Embase and Web of Science. We will include peer-reviewed and grey literature published in English or French from 2010 onward. Two reviewers will independently screen titles, abstracts and full texts in Covidence, with disagreements resolved by consensus or a third reviewer. Data will be extracted using a standardised form to capture study characteristics, ICD codes, definitions of heat exposure and approaches to measurement. A descriptive and thematic analysis will be conducted, and findings will be presented narratively and in tables.

Ethical approval is not required for this review as it involves secondary analysis of published and publicly available data; for more information, contact University of Montreal’s Research Integrity department at plaintes-crr@umontreal.ca. Results will be published through a peer-reviewed publication, conference presentations and knowledge transfer activities with public health stakeholders in Québec. This review contributes to the MEDICCS (Modélisation économique des impacts des changements climatiques sur la santé) project and will support recommendations for improving the capture of heat-related morbidity in health administrative data.

Dysregulated immunity may account for an increased risk of infection and other adverse outcomes among frail hospitalised persons. The primary objective of this study is to examine whether baseline frailty is associated with the risk of developing ventilator-associated pneumonia (VAP) or other intensive care unit (ICU)-acquired infections among invasively ventilated adults. Additional objectives are to examine the relationship between frailty and hospital length of stay, discharge to a long-term care facility and vital status. We hypothesise that persons with frailty compared with others would have an increased risk of VAP and other infections, a longer hospital stay, higher probability of discharge to a long-term care facility and higher mortality.

This is a preplanned secondary analysis of the PROSPECT trial (Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial) which enrolled patients across 44 ICUs in three countries. We will use Cox proportional hazards regression analysis to assess the association of frailty with the clinical outcomes of interest, adjusting for other baseline variables. Baseline demographic and descriptive outcome data will be reported using descriptive statistics. Regression results will be presented as adjusted HRs or ORs with 95% CIs for the associations of each independent variable with the primary, secondary and tertiary outcomes.

Participating hospital research ethics board approved the PROSPECT trial and data collection. The protocol for this study was approved by the Hamilton Integrated Research Ethics Board on 20 August 2015 (Project ID:19128). This study will identify whether frailty is associated with risk of VAP and other healthcare-associated infections in invasively ventilated patients, adjusted for other baseline factors. Results may be useful to patients, their caregivers, clinicians and the design of future research. Findings will be disseminated to investigators at a meeting of the Canadian Critical Care Trials Group. We will present study results at an international conference in the fields of critical care and infectious diseases, to coincide with or precede open-access peer-review publication. To aid knowledge dissemination, we will use a variety of formats. For example, for traditional and social media, we will create two different visual abstracts and infographics of our results suitable to share on clinician-facing and public-facing platforms.

NCT02462590.