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Dravid A, Sung WS, Song J, Dubey A, Eftekhar B. Subarachnoid Haemorrhage Incidence Pattern Analysis with Circular Statistics. Emerg Med Int 2024; 2024:6631990. [PMID: 38655008 PMCID: PMC11039014 DOI: 10.1155/2024/6631990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/27/2023] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Knowledge about biological rhythms of diseases may not only help in understanding the pathophysiology of diseases but can also help health service policy makers and emergency department directors to allocate resources efficiently. Aneurysmal subarachnoid haemorrhage (SAH) has high rates of morbidity and mortality. The incidence of SAH has been attributed to patient-related factors such as characteristics of aneurysms, smoking, and hypertension. There are studies showing that the incidence of aneurysmal SAH appears to behave in periodic fashions over long time periods. However, there are inconsistencies in the literature regarding the impact of chronobiological factors such as circadian, seasonal, and lunar cycle factors on the occurrence of SAH. In this study, we focused on the analysis of a temporal pattern of SAH (infradian rhythms) with a novel approach using circular statistical methods. We aimed to see whether there is a circular pattern for the occurrence of SAH at all and if so, whether it can be related to known temporal patterns based on available literature. Our study did not support the notion that aneurysmal subarachnoid haemorrhages occur on any specific day in a cycle with specific lengths up to 365 days including specific weekdays, full moon, equinoxes, and solstices. Hence, we found no relationship between SAH incidence and timing. Study in larger populations using similar circular statistical methods is suggested.
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Affiliation(s)
- Ashish Dravid
- Department of Neurosurgery, Nepean Hospital, The University of Sydney, Sydney, Australia
| | - Wen-Shan Sung
- Department of Neurosurgery, Royal Hobart Hospital, Hobart, Australia
| | - Jeeuk Song
- Department of Neurosurgery, Royal Hobart Hospital, Hobart, Australia
| | - Arvind Dubey
- Department of Neurosurgery, Royal Hobart Hospital, Hobart, Australia
| | - Behzad Eftekhar
- Department of Neurosurgery, Nepean Hospital, The University of Sydney, Sydney, Australia
- Department of Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
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Malka D, Janot K, Pasi M, Desilles JP, Marnat G, Sibon I, Consoli A, Dargazanli C, Arquizan C, Gory B, Richard S, Naggara O, Clarençon F, Rosso C, Bourcier R, Eker O, Caroff J, Lapergue B, Boulouis G. Effects of weather conditions on endovascular treatment case volume for patients with ischemic stroke. J Neuroradiol 2023; 50:593-599. [PMID: 37442271 DOI: 10.1016/j.neurad.2023.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Weather conditions have been shown to influence the occurrence of cardiovascular events. We tested the hypothesis that weather parameters may be associated with variations of case volume of endovascular treatment (EVT) for acute ischemic stroke. METHODS Individual data from the ETIS (Endovascular Treatment in Ischemic Stroke) French national registry were matched to local weather stations. Meteorological parameters (rainfall, humidity, atmospheric pressure, air temperature) were gathered from national online resources. Weather readings and EVT case volumes were annually standardized per weather station and EVT center, and their associations tested with non-parametric univariable and generalized linear statistical models. RESULTS Between 2015 and 2021, 9913 EVT procedures addressed by 135 primary stroke units were matched to weather conditions. The mean daily case volume per center was 0.41 [StDev 0.33], and there was a median of 0.84 procedures daily linked to a weather station [StDev 0.47]. We found lower atmospheric pressure (β estimate -0.04; 95%CI[-0.07;-0.03], p<0.001), higher humidity (β estimate 0.07; 95%CI [0.05;0.09], p<0.001) and lower temperatures (β estimate -0.08; 95%CI[-0.10;-0.06], p<0.001) to be associated with higher standardized EVT daily case volumes. These associations were stable when testing them across strata of binned EVT standardized case volumes. CONCLUSIONS Our study suggests that lower ambient temperature, lower atmospheric pressure, and higher air humidity are associated with significantly more daily EVT cases in a European temperate country. These results may provide insight into both system of care optimization at times of climate change and intracranial LVO pathophysiology. REGISTRATION-URL: https://clinicaltrials.gov/ct2/show/NCT03776877.
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Affiliation(s)
- David Malka
- Diagnostic and Interventional Neuroradiology Department, Tours University Hospital, INSERM UMR 1253 iBrain, 2 Bd Tonnellé, Centre Val de Loire, Tours, France
| | - Kevin Janot
- Diagnostic and Interventional Neuroradiology Department, Tours University Hospital, INSERM UMR 1253 iBrain, 2 Bd Tonnellé, Centre Val de Loire, Tours, France
| | - Marco Pasi
- Stroke Unit, Tours University Hospital, INSERM UMR 1253 iBrain, Tours, Centre Val de Loire, France
| | - Jean-Philippe Desilles
- Interventional Neuroradiology Department, Biological Resource Center, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Gaultier Marnat
- Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | - Igor Sibon
- Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | - Arturo Consoli
- Department of Neuroradiology and Stroke Unit, Foch Hospital, Suresnes, France, University of Versailles Saint-Quentin-des-Yvelines, France
| | - Cyril Dargazanli
- Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Hospital Center, Montpellier, France
| | - Caroline Arquizan
- Stroke Unit, Gui de Chauliac Hospital, Montpellier University Hospital Center, Montpellier, France
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Nancy F-54000, France; IADI, INSERM U1254, Université de Lorraine (B.G.), Nancy F-54000, France
| | - Sébastien Richard
- CHRU-Nancy, Department of Neurology, Stroke Unit, Nancy F-54000, France; CHRU-Nancy, CIC-P 1433 (S.R.), INSERM U1116, Nancy F-54000, France
| | - Olivier Naggara
- Department of Neuroradiology, INSERM 1266 IMABRAIN, Saint Anne Hospital Centre, Île-de-France, Paris, France
| | | | - Charlotte Rosso
- APHP-Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Inserm U 1127, CNRS UMR 7225, Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, Sorbonne Université, UPMC Univ Paris 06 UMR S 1127, Paris F-75013, France
| | - Romain Bourcier
- CHU Nantes, CNRS, INSERM, l'institut du thorax, Institut du thorax Nantes Université, 14 Lyon HCL, Nantes F-44000, France
| | - Omer Eker
- Neuroradiolology Department, Hospices Civils de Lyon, Lyon, France
| | - Jildaz Caroff
- Neuroradiolology Department, CHU Kremlin Bicêtre, Paris, France
| | - Bertrand Lapergue
- Department of Neuroradiology and Stroke Unit, Foch Hospital, Suresnes, France, University of Versailles Saint-Quentin-des-Yvelines, France
| | - Grégoire Boulouis
- Diagnostic and Interventional Neuroradiology Department, Tours University Hospital, INSERM UMR 1253 iBrain, 2 Bd Tonnellé, Centre Val de Loire, Tours, France.
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Sayore C, Ouambi LI, Bechri H, Kaoukou F, Oudrhiri M, Boutarbouch M, Ouahabi A. Influence of seasonal factors on the incidence of ruptured intracranial aneurysms: Moroccan fifteen years’ experience. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Huang Q, Sun Y, Lu J, Huang QY, Zeng YL, Liu B, Xu XY, Cai YY, Lin SW, Li HY, Wu SY. Associations between meteorological variation and rupture of intracranial aneurysm in Fujian, China: A 5-year multicenter study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 223:112609. [PMID: 34385062 DOI: 10.1016/j.ecoenv.2021.112609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/21/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE By exploring the exposure-response relationships between meteorological factors and rupture of intracranial aneurysm (IA) to reveal the influence of meteorological variation on IA rupture under the specific climate in Fujian, China. METHOD 7515 cases of IA rupture from several municipal medical institutions in Fujian Province as well as local meteorological data during the same period were collected from 2013 to 2017. Poisson regression and Spearman correlation analysis were applied to explore the distribution characteristics of IA rupture and how it is associated with meteorological parameters. Poisson generalized additive model was established to further analyze the exposure-response relationships between meteorological factors and IA rupture, and its hysteresis effects. RESULT The IA rupture exhibited a negative correlation with temperature (rs = -0.323, 95% CI: -0.539 ~ -0.068) and a positive correlation with atmospheric pressure (rs = 0.397, 95% CI: 0.152-0.597) or pressure difference (rs = 0.296, 95% CI: 0.038-0.517), 21.05 ℃ and 1000.14 hPa were the risk thresholds for the onset ascribed to variation in temperature and atmospheric pressure, respectively. Temperature and atmospheric pressure also exerted hysteresis effects on IA rupture. Cold will increase the rupture risk in the subsequent 1-3 days, and high pressure will raise the morbidity in the next 1-2 days. Besides, drastic variations in temperature and atmospheric pressure were also associated with the higher risk of IA rupture in the next 2 days and 1 day, respectively. CONCLUSION Temperature and atmospheric pressure have a negative and positive correlation with IA rupture in Fujian, China, respectively. Variation in temperature and atmospheric pressure exert different degrees of hysteresis effects on IA rupture.
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Affiliation(s)
- Qing Huang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yi Sun
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jing Lu
- Longyan First Hospital Affiliated to Fujian Medical University, Longyan, China
| | - Qiu-Yu Huang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yi-Le Zeng
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Bang Liu
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xing-Yan Xu
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Ying-Ying Cai
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Shao-Wei Lin
- School of Public Health, Fujian Medical University, Fuzhou, China.
| | - Huang-Yuan Li
- School of Public Health, Fujian Medical University, Fuzhou, China.
| | - Si-Ying Wu
- School of Public Health, Fujian Medical University, Fuzhou, China.
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Kockler M, Schlattmann P, Walther M, Hagemann G, Becker PN, Rosahl S, Witte OW, Schwab M, Rakers F. Weather conditions associated with subarachnoid hemorrhage: a multicenter case-crossover study. BMC Neurol 2021; 21:283. [PMID: 34281522 PMCID: PMC8287714 DOI: 10.1186/s12883-021-02312-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most spontaneous subarachnoid hemorrhages (SAH) occur unexpectedly and independently of classical risk factors. In the light of increasing climate variability and change, we investigated weather and rapid weather changes as possible short-term risk factors for SAH. METHODS Seven hundred ninety one patients admitted to three major hospitals in Germany for non-traumatic SAH with a determinable onset of SAH symptoms were included in this hospital-based, case-crossover study. The effects of atmospheric pressure, relative air humidity, and ambient temperature and their 24 h changes on the onset of SAH under temperate climate conditions were estimated. RESULTS There was no association between the risk of SAH and 24 h weather changes, mean daily temperature or mean relative air humidity in the overall population. For every 11.5 hPa higher mean daily atmospheric pressure, the risk of SAH increased by 15% (OR 1.15, 95% confidence interval (CI) 1.01-1.30) in the entire study population with a lag time of three days. CONCLUSION Our results suggest no relevant association between 24 h-weather changes or absolute values of ambient temperature and relative humidity and the risk of SAH. The medical significance of the statistically weak increase in SAH risk three days after exposure to high atmospheric pressure is unclear. However, as the occurrence of stable high-pressure systems will increase with global warming and potentially affect SAH risk, we call for confirming studies in different geographical regions to verify our observations.
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Affiliation(s)
- Michael Kockler
- Hans-Berger Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Peter Schlattmann
- Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, 07747, Jena, Germany
| | - Mario Walther
- Department of Fundamental Sciences, Ernst Abbe University of Applied Sciences, 07745, Jena, Germany
| | - Georg Hagemann
- Department of Neurology, HELIOS Hospital Berlin-Buch, 13125, Berlin, Germany
| | - Philipp Nils Becker
- Department of Neurology, HELIOS Hospital Berlin-Buch, 13125, Berlin, Germany
| | - Steffen Rosahl
- Department of Neurosurgery, HELIOS Hospital Erfurt, 99089, Erfurt, Germany
| | - Otto W Witte
- Hans-Berger Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Matthias Schwab
- Hans-Berger Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Florian Rakers
- Hans-Berger Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany. .,Department of Neurology, HELIOS Hospital Berlin-Buch, 13125, Berlin, Germany.
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Helsper M, Agarwal A, Aker A, Herten A, Darkwah-Oppong M, Gembruch O, Deuschl C, Forsting M, Dammann P, Pierscianek D, Jabbarli R, Sure U, Wrede KH. The Subarachnoid Hemorrhage-Weather Myth: A Long-Term Big Data and Deep Learning Analysis. Front Neurol 2021; 12:653483. [PMID: 34025556 PMCID: PMC8131675 DOI: 10.3389/fneur.2021.653483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/22/2021] [Indexed: 12/12/2022] Open
Abstract
Objective: The frequency of aneurysmal subarachnoid hemorrhage (aSAH) presents complex fluctuations that have been attributed to weather and climate changes in the past. In the present long-term big data and deep learning analysis, we have addressed this long-held myth. Methods: Bleeding dates and basic demographic data for all consecutive patients (n = 1,271) admitted to our vascular center for treatment of aSAH between January 2003 and May 2020 (6,334 days) were collected from our continuously maintained database. The meteorological data of the local weather station, including 13 different weather and climate parameters, were retrieved from Germany's National Meteorological Service for the same period. Six different deep learning models were programmed using the Keras framework and were trained for aSAH event prediction with meteorological data from January 2003 to June 2017, with 10% of this dataset applied for data validation and model improvement. The dataset from July 2017 to May 2020 was tested for aSAH event prediction accuracy for all six models using the area under the receiver operating characteristic curve (AUROC) as the metric. Results: The study group comprised of 422 (33.2%) male and 849 (66.8%) female patients with an average age of 55 ± 14 years. None of the models showed an AUROC larger than 60.2. From the presented data, the influence of weather and climate on the occurrence of aSAH events is extremely unlikely. Conclusion: The myth of special weather conditions influencing the frequency of aSAH is disenchanted by this long-term big data and deep learning analysis.
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Affiliation(s)
- Moritz Helsper
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Aashish Agarwal
- Department of Computer Science and Applied Cognitive Science, University of Duisburg-Essen, Duisburg, Germany
| | - Ahmet Aker
- Department of Computer Science and Applied Cognitive Science, University of Duisburg-Essen, Duisburg, Germany
| | - Annika Herten
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Marvin Darkwah-Oppong
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Oliver Gembruch
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Cornelius Deuschl
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany
| | - Michael Forsting
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany
| | - Philipp Dammann
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniela Pierscianek
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karsten Henning Wrede
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Fukuda H, Ninomiya H, Ueba Y, Ohta T, Kaneko T, Kadota T, Hamada F, Fukui N, Nonaka M, Watari Y, Nishimoto S, Fukuda M, Hayashi S, Izumidani T, Nishimura H, Moriki A, Lo B, Ueba T. Impact of temperature decline from the previous day as a trigger of spontaneous subarachnoid hemorrhage: case-crossover study of prefectural stroke database. J Neurosurg 2020; 133:374-382. [PMID: 31277067 DOI: 10.3171/2019.4.jns19175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/17/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Several environmental factors have been reported to correlate with incidence of spontaneous subarachnoid hemorrhage (SAH). However, because of different patient selection and study designs among these studies, meteorological factors that trigger the incidence of SAH in a short hazard period remain unknown. Among meteorological factors, daily temperature changes may disrupt and violate homeostasis and predispose to cerebrovascular circulatory disturbances and strokes. The authors aimed to investigate whether a decline in the temperature from the highest of the previous day to the lowest of the event day (temperature decline from the previous day [TDP]) triggers SAH in the prefecture-wide stroke database. METHODS All 28 participating institutions with primary or comprehensive stroke centers located throughout Kochi Prefecture, Japan, were included in the study. Data collected between January 2012 and December 2016 were analyzed, and 715 consecutive SAH patients with a defined date of onset were enrolled. Meteorological data in this period were obtained from the Kochi Local Meteorological Observatory. A case-crossover study was performed to investigate association of TDP and other environmental factors with onset of SAH. RESULTS The increasing TDP in 1°C on the day of the SAH event was associated with an increased incidence of SAH (OR 1.041, 95% CI 1.007-1.077) after adjustment for other environmental factors. According to the stratified analysis, a significant association between TDP and SAH was observed in women, patients < 65 years old, and patients with weekday onset. Among these factors, increasing TDP had a great impact on SAH onset in patients < 65 years old (p = 0.028, Mann-Whitney U-test). CONCLUSIONS TDP, temperature decline from the highest of the previous day to the lowest of the day, was correlated with the incidence of spontaneous SAH, particularly in younger patients < 65 years old.
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Affiliation(s)
| | - Hitoshi Ninomiya
- 1Department of Neurosurgery and
- 2Integrated Center for Advanced Medical Technologies, Kochi University Hospital
| | | | - Tsuyoshi Ohta
- 3Department of Neurosurgery, Kochi Health Sciences Center
| | | | | | | | | | | | - Yuya Watari
- 5Department of Neurosurgery, Kochi Red Cross Hospital
| | | | - Maki Fukuda
- 3Department of Neurosurgery, Kochi Health Sciences Center
| | | | | | | | - Akihito Moriki
- 7Department of Neurosurgery, Mominoki Hospital, Kochi, Japan; and
| | - Benjamin Lo
- 8Department of Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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Meteorological factors for subarachnoid hemorrhage in the greater Düsseldorf area revisited: a machine learning approach to predict the probability of admission of patients with subarachnoid hemorrhage. Acta Neurochir (Wien) 2020; 162:187-195. [PMID: 31760531 DOI: 10.1007/s00701-019-04128-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Reported data regarding the relation between the incidence of spontaneous subarachnoid hemorrhage (SAH) and weather conditions are conflicting and do so far not allow prognostic models. METHODS Admissions for spontaneous SAH (ICD I60.*) 2009-2018 were retrieved form our hospital data base. Historical meteorological data for the nearest meteorological station, Düsseldorf Airport, was retrieved from the archive of the Deutsche Wetterdienst (DWD). Airport is in the center of our catchment area with a diameter of approximately 100 km. Pearson correlation matrix between mean daily meteorological variables and the daily admissions of one or more patients with subarachnoid hemorrhage was calculated and further analysis was done using deep learning algorithms. RESULTS For the 10-year period from January 1, 2009 until December 31, 2018, a total of 1569 patients with SAH were admitted. No SAH was admitted on 2400 days (65.7%), 1 SAH on 979 days (26.7%), 2 cases on 233 days (6.4%), 3 SAH on 37 days (1.0%), 4 in 2 days (0.05%), and 5 cases on 1 day (0.03%). Pearson correlation matrix suggested a weak positive correlation of admissions for SAH with precipitation on the previous day and weak inverse relations with the actual mean daily temperature and the temperature change from the previous days, and weak inverse correlations with barometric pressure on the index day and the day before. Clustering with admission of multiple SAH on a given day followed a Poisson distribution and was therefore coincidental. The deep learning algorithms achieved an area under curve (AUC) score of approximately 52%. The small difference from 50% appears to reflect the size of the meteorological impact. CONCLUSION Although in our data set a weak correlation of the probability to admit one or more cases of SAH with meteorological conditions was present during the analyzed time period, no helpful prognostic model could be deduced with current state machine learning methods. The meteorological influence on the admission of SAH appeared to be in the range of only a few percent compared with random or unknown factors.
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Role of bioclimate conditions on cerebral aneurysm rupture in the Brittany region of France. Neurochirurgie 2019; 66:9-15. [PMID: 31836487 DOI: 10.1016/j.neuchi.2019.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/30/2019] [Accepted: 11/03/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Subarachnoid hemorrhage (SAH) from intracranial aneurysm rupture is an unpredictable event responsible for significant morbidity and mortality. Despite inconsistencies, some studies suggest a potential role of climate conditions in SAH onset. The purpose of this study was to determine the impact of climatic and lunar factors on onset of SAH in an oceanic climate such as that of Brittany, France. METHODS All adults with SAH admitted to the neurosurgery department and intensive care unit of the University Hospital of Rennes (France) between January 1st, 2011 and December 31st, 2012 were included. Meteorological variables, their variations, lunar phases and tidal coefficients were compared between days with and without SAH. RESULTS We retrospectively included 295 patients with SAH. Mean minimum temperature was significantly lower during days with SAH (7.7±4.7°C versus 8.3±4.6°C; P=0.039); temperature variation between 2 successive days was significantly greater for days with SAH (8.6±4.1°C versus 7.9±3.8°C; P<0.01). Multivariate analysis showed that a 2-day temperature drop greater than or equal to 8°C was associated with 35% increased risk of SAH (odds ratio 1.35 [1.03-1.77]). There were no significant effects of other meteorological variables, lunar phase or tidal coefficient on SAH occurrence. CONCLUSION Low temperature and sudden temperature drop were associated with increased occurrence of SAH in Brittany, France.
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Li M, Hu S, Yu N, Zhang Y, Luo M. Association Between Meteorological Factors and the Rupture of Intracranial Aneurysms. J Am Heart Assoc 2019; 8:e012205. [PMID: 31438768 PMCID: PMC6755857 DOI: 10.1161/jaha.119.012205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Both meteorological factors and morphological factors are important factors to predict intracranial aneurysm rupture. This study investigated the relationship between meteorological factors and aneurysmal subarachnoid hemorrhage (aSAH). Additionally, the morphological differences between ruptured and unruptured aneurysms under these high-risk meteorological conditions were assessed. Methods and Results The records of 1751 patients with aSAH with 2124 intracranial aneurysms were retrospectively analyzed. Spearman rank correlation analysis was used to assess the risks of incident aSAH on the basis of daily meteorological data. Morphological parameters were analyzed using 1-way ANOVA tests, and significant parameters (P<0.05) were further examined using a multivariable logistic regression analysis. Daily aSAH incidence had significant negative correlations with daily mean, maximum, and minimum temperature (P<0.001) and a significant positive correlation with daily mean atmospheric pressure (P<0.001). Additionally, 58 patients with multiple aneurysms were assessed to determine morphological differences. There were significant differences in the mean values for aneurysm size, neck width, length, height, width, parent artery diameter, shape of the aneurysm, aspect ratio, size ratio, and bottleneck factor (P<0.05). The multivariable logistic regression analysis showed that aspect ratio (β=1.277, odds ratio=3.585, 95% CI, 1.588-8.090; P=0.002) was an independent risk factor for aneurysm rupture. Receiver operating characteristic curve analysis indicated that the ruptured aneurysm threshold of size was 3.45 mm and aspect ratio was 1.05. Conclusions Lower daily mean, maximum, and minimum temperatures and a higher daily mean atmospheric pressure were associated with an increased rate of aSAH. Additionally, under these meteorological conditions, the aneurysm size and aspect ratio thresholds for predicting rupture of an aneurysm may be lower.
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Affiliation(s)
- MeiHua Li
- Department of Neurosurgery the First Affiliated Hospital of Nanchang University Nanchang China
| | - Si Hu
- Department of Neurosurgery the First Affiliated Hospital of Nanchang University Nanchang China
| | - NianZu Yu
- Department of Neurosurgery the First Affiliated Hospital of Nanchang University Nanchang China
| | - Ying Zhang
- Jiangxi Meteorological Observatory Nanchang China
| | - Muyun Luo
- Department of Neurosurgery the First Affiliated Hospital of Gannan Medical University Ganzhou China
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Huang Q, Lin SW, Hu WP, Li HY, Yao PS, Sun Y, Zeng YL, Huang QY, Kang DZ, Wu SY. Meteorological Variation Is a Predisposing Factor for Aneurismal Subarachnoid Hemorrhage: A 5-Year Multicenter Study in Fuzhou, China. World Neurosurg 2019; 132:e687-e695. [PMID: 31442657 DOI: 10.1016/j.wneu.2019.08.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/07/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The climatic characteristics of aneurysmal subarachnoid hemorrhage (aSAH) have been reported, but consensus has not yet been reached. It is of great significance to elucidate the relationships between meteorological variation and aSAH in regions with specific climate patterns. We analyzed the occurrence of aSAH in the capital city of Fujian Province, China, through a multicenter, 5-year study, and aimed to reveal the meteorological influences on aSAH in the coastal city of eastern Fujian under the subtropical marine monsoon condition. METHODS A total of 2555 consecutive patients with aSAH in Fuzhou were collected using specialized stroke admission database from January 2013 to December 2017. Meteorological parameters including temperature, atmospheric pressure, and humidity were obtained from China Surface Meteorological Station during the same period. Poisson regression was used to explore the association between meteorological parameters and aSAH to calculate the incidence rate ratios (IRRs) with corresponding 95% confidence intervals (CIs). Generalized additive model analysis further revealed the nonlinear relationships between weather and aSAH. RESULTS Daily minimum temperature (IRR 0.976, 95% CI 0.958-0.996) and maximum pressure (IRR 1.022, 95% CI 1.001-1.042) were independently correlated with the onset of aSAH. Low temperature (below 16°C) and excessive atmospheric pressure (above 1008 hPa) increased the risk of aSAH. In addition, March in spring and December in winter were the 2 ictus peaks in Fuzhou throughout the year. CONCLUSIONS Cold and excessive atmospheric pressure are triggers for the occurrence of aSAH; March in spring and December in winter are the predominant onset periods in Fuzhou.
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Affiliation(s)
- Qing Huang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China; School of Public Health, Fujian Medical University, Fuzhou, China
| | - Shao-Wei Lin
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Wei-Peng Hu
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Huang-Yuan Li
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Pei-Sen Yao
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yi Sun
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yi-Le Zeng
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qiu-Yu Huang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - De-Zhi Kang
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Si-Ying Wu
- School of Public Health, Fujian Medical University, Fuzhou, China.
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Petridis AK, Kamp MA, Cornelius JF, Beez T, Beseoglu K, Turowski B, Steiger HJ. Aneurysmal Subarachnoid Hemorrhage. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 114:226-236. [PMID: 28434443 DOI: 10.3238/arztebl.2017.0226] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 08/29/2016] [Accepted: 11/28/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND Aneurysmal subarachnoid hemorrhage (SAH) is associated with a mortality of more than 30%. Only about 30% of patients with SAB recover sufficiently to return to independent living. METHODS This article is based on a selective review of pertinent literature retrieved by a PubMed search. RESULTS Acute, severe headache, typically described as the worst headache of the patient's life, and meningismus are the characteristic manifestations of SAH. Computed tomog raphy (CT) reveals blood in the basal cisterns in the first 12 hours after SAH with approximately 95% sensitivity and specificity. If no blood is seen on CT, a lumbar puncture must be performed to confirm or rule out the diagnosis of SAH. All patients need intensive care so that rebleeding can be avoided and the sequelae of the initial bleed can be minimized. The immediate transfer of patients with acute SAH to a specialized center is crucially important for their outcome. In such centers, cerebral aneurysms can be excluded from the circulation either with an interventional endovascular procedure (coiling) or by microneurosurgery (clipping). CONCLUSION SAH is a life-threatening condition that requires immediate diagnosis, transfer to a neurovascular center, and treatment without delay.
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Affiliation(s)
- Athanasios K Petridis
- Department of Neurosurgery, Düsseldorf University Hospital; Department of Diagnostic and Interventional Radiology, Düsseldorf University Hospital; Department of Diagnostic and Interventional Radiology, Düsseldorf University Hospital
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13
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van Donkelaar CE, Potgieser ARE, Groen H, Foumani M, Abdulrahman H, Sluijter R, van Dijk JMC, Groen RJM. Atmospheric Pressure Variation is a Delayed Trigger for Aneurysmal Subarachnoid Hemorrhage. World Neurosurg 2018; 112:e783-e790. [PMID: 29409775 DOI: 10.1016/j.wneu.2018.01.155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE There is an ongoing search for conditions that induce spontaneous subarachnoid hemorrhage (SAH). The seasonal pattern of SAH is shown in a large meta-analysis of the literature, but its explanation remains undecided. There is a clear need for sound meteorologic data to further elucidate the seasonal influence on SAH. Because of the stable and densely monitored atmospheric situation in the north of the Netherlands, we reviewed our unique cohort on the seasonal incidence of SAH and the association between SAH and local atmospheric changes. METHODS Our observational cohort study included 1535 patients with spontaneous SAH admitted to our neurovascular center in the north of the Netherlands between 2000 and 2015. Meteorologic data could be linked to the day of the ictus. To compare SAH incidences over the year and to test the association with meteorologic conditions, incidence rate ratios (IRRs) with corresponding 95% confidence intervals (CIs) were used, calculated by Poisson regression analyses. RESULTS Atmospheric pressure variations were significantly associated with aneurysmal SAH. In particular, the pressure change on the second and third day before the ictus was independently correlated to a higher incidence of aneurysmal SAH (IRR, 1.11; 95% CI, 1.00-1.23). The IRR for aneurysmal SAH in July was calculated 0.67 (95% CI, 0.49-0.92) after adjustment for temperature and atmospheric pressure changes. CONCLUSIONS Atmospheric pressure variations are a delayed trigger for aneurysmal SAH. Also, a significantly decreased incidence of aneurysmal SAH was noted in July.
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Affiliation(s)
- Carlina E van Donkelaar
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Adriaan R E Potgieser
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mahrouz Foumani
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Herrer Abdulrahman
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rob Sluijter
- Royal Netherlands Meteorological Institute, De Bilt, The Netherlands
| | - J Marc C van Dijk
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rob J M Groen
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Han MH, Kim J, Choi KS, Kim CH, Kim JM, Cheong JH, Yi HJ, Lee SH. Monthly variations in aneurysmal subarachnoid hemorrhage incidence and mortality: Correlation with weather and pollution. PLoS One 2017; 12:e0186973. [PMID: 29073210 PMCID: PMC5658131 DOI: 10.1371/journal.pone.0186973] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/11/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND PURPOSE Although the effect of weather and air pollution on the occurrence of subarachnoid hemorrhage (SAH) has been investigated, results have remained inconsistent. The present study aimed to determine the seasonality of aneurysmal subarachnoid hemorrhage occurrence and mortality. METHODS We used the National Inpatient Sample database to evaluate the effect of meteorological factors and air pollutants on patients with subarachnoid hemorrhage in Korea between 2011 and 2014. Monthly variations in SAH occurrence and mortality were analyzed using locally weighted scatter plot smoothing curves. Multivariate Poisson generalized linear regression models were used to evaluate potential independent meteorological and pollutant variables associated with SAH occurrence and mortality. RESULTS In total, 21,407 patients who underwent clip or coil treatment owing to aneurysmal SAH in Korea from January 1, 2011, to December 31, 2014, were included. The crude incidence rate of SAH in Korea was 10.5 per 100,000 people per year. An approximately 0.5% lower risk of SAH was observed per 1°C increase in mean monthly temperature (relative risk, 0.995; 95% confidence interval [CI], 0.992-0.997; p < 0.001), while an approximately 2.3% higher risk of SAH was observed per 1°C increase in mean monthly diurnal temperature. CONCLUSIONS We showed distinct patterns of seasonal and monthly variation in the occurrence and mortality of SAH. Our findings suggest that meteorological factors may play an important role in monthly variations in the occurrence of aneurysmal SAH.
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Affiliation(s)
- Myung-Hoon Han
- Department of Neurosurgery, Hanyang University Guri Hospital, Gyeongchun-ro, Guri, Gyonggi-do, Korea
| | - Jinhee Kim
- Department of Nursing, College of Medicine, Chosun University, Gwangju, Korea
| | - Kyu-Sun Choi
- Department of Neurosurgery, Hanyang University Medical Center, Wangsimni-ro, Seongdong-gu, Seoul, Korea
| | - Choong Hyun Kim
- Department of Neurosurgery, Hanyang University Guri Hospital, Gyeongchun-ro, Guri, Gyonggi-do, Korea
| | - Jae Min Kim
- Department of Neurosurgery, Hanyang University Guri Hospital, Gyeongchun-ro, Guri, Gyonggi-do, Korea
| | - Jin Hwan Cheong
- Department of Neurosurgery, Hanyang University Guri Hospital, Gyeongchun-ro, Guri, Gyonggi-do, Korea
| | - Hyeong-Joong Yi
- Department of Neurosurgery, Hanyang University Medical Center, Wangsimni-ro, Seongdong-gu, Seoul, Korea
| | - Seon Heui Lee
- Department of Nursing Science, College of Nursing, Gachon University, Hambangmoe-ro, Yeonsu-gu, Incheon, Korea
- * E-mail:
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Internet search volumes in brain aneurysms and subarachnoid hemorrhage: Is there evidence of seasonality? Clin Neurol Neurosurg 2017; 158:1-4. [DOI: 10.1016/j.clineuro.2017.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 11/23/2022]
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Lee S, Guth M. Associations between Temperature and Hospital Admissions for Subarachnoid Hemorrhage in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040449. [PMID: 28430143 PMCID: PMC5409649 DOI: 10.3390/ijerph14040449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/17/2017] [Accepted: 04/19/2017] [Indexed: 11/16/2022]
Abstract
The relationship between temperature and subarachnoid hemorrhage (SAH) is less studied than that between temperature and myocardial infarction or other cardiovascular diseases. This study investigated the association between daily temperature and risk of SAH by analyzing the hospital admission records of 111,316 SAH patients from 2004 to 2012 in Korea. A Poisson regression model was used to examine the association between temperature and daily SAH hospital admissions. To analyze data and identify vulnerable groups, we used the following subgroups: sex, age, insurance type, area (rural or urban), and different climate zones. We confirmed a markedly higher SAH risk only for people of low socioeconomic status in both hot and cold temperatures; the relative risk (RR) in the Medicaid group was significantly increased and ranged from 1.04 to 1.11 for cold temperatures and 1.10 to 1.11 for hot temperatures. For the National Health Insurance group, the RR was increased to 1.02 for the maximum temperature only. The increased risk for SAH was highest in the temperate zone. An increase above the heat threshold temperature and a decrease below the cold threshold temperature were correlated with an increased risk of SAH in susceptible populations and were associated with different lag effects and RRs.
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Affiliation(s)
- Suji Lee
- Institute of Health and Environment, Seoul National University, Gwanak-gu, Seoul 151-742, Korea.
| | - Matthias Guth
- School of Medicine, Technische Universität München, Arcisstraße 21, 80333 Munich, Germany.
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Patrice T, Rozec B, Desal H, Blanloeil Y. Oceanic Meteorological Conditions Influence Incidence of Aneurysmal Subarachnoid Hemorrhage. J Stroke Cerebrovasc Dis 2017; 26:1573-1581. [PMID: 28318957 DOI: 10.1016/j.jstrokecerebrovasdis.2017.02.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/09/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Publications concerning the weather pattern of occurrence of the subarachnoid hemorrhage have produced controversial results. We chose to study subarachnoid hemorrhage occurring in oceanic climate with deep variations focusing on partial oxygen volume (pO2) and patient history. METHODS Seventy-one patients had been successively recruited from a single center 45 km from the Atlantic shore. Climate conditions had been analyzed from 72 hours before subarachnoid hemorrhage to 24 hours after. According to Dalton's law, climate conditions influence pO2, recalculated with Dupré's formula, and patient history analyzed and scored according to the induced oxidative stress. RESULTS Subarachnoid hemorrhage risk is highest during spring and autumn, lowest between midnight and 6:00 a.m. Risk is highest after a period of atmospheric pressure higher than 1010 hPa (83%) and high pO2 and lowest for atmospheric pressure lower than 990 hPa and pO2 lower than 20.6. According to the medical history, 2 groups of patients could be identified: patients without history (22%), women (62%), high atmospheric pressure, and relatively lower pO2; and patients with a medical history, relatively lower atmospheric pressure, and higher pO2. Atmospheric pressure decreased significantly before disruption (994 hPa) but with a constant pO2. Subarachnoid hemorrhages during high atmospheric pressure were preceded by a decrease of pO2 despite a highly stable period of high atmospheric pressure. DISCUSSION Atmospheric O2 changes and the subsequent oxidative stress could be the local ultimate trigger of subarachnoid hemorrhage that could result in the "ideal" fit of patient's health conditions with the meteorological environment.
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Affiliation(s)
- Thierry Patrice
- Anesthesiology and Intensive Care, Laënnec Hospital, University Hospital Nantes, Nantes, France.
| | - Bertrand Rozec
- Anesthesiology and Intensive Care, Laënnec Hospital, University Hospital Nantes, Nantes, France
| | - Hubert Desal
- Anesthesiology and Intensive Care, Laënnec Hospital, University Hospital Nantes, Nantes, France
| | - Yvonnick Blanloeil
- Anesthesiology and Intensive Care, Laënnec Hospital, University Hospital Nantes, Nantes, France
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18
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Han MH, Yi HJ, Ko Y, Kim YS, Lee YJ. Association between hemorrhagic stroke occurrence and meteorological factors and pollutants. BMC Neurol 2016; 16:59. [PMID: 27146603 PMCID: PMC4855484 DOI: 10.1186/s12883-016-0579-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 04/26/2016] [Indexed: 12/11/2022] Open
Abstract
Background The purpose of this study is to determine whether intracerebral hemorrhage and subarachnoid hemorrhage have different incidence patterns based on monthly variations in meteorological and air pollution parameters in the Seongdong district of Seoul, South Korea. Methods From January 1, 2004 to December 31, 2014, 1,477 consecutive hemorrhagic stroke events (>19 years old) were registered among residents of the Seongdong district, Seoul, South Korea. The authors calculated the relative risk of hemorrhagic stroke and its subtype incidence based on meteorological and air pollution factors. We also estimated relative risk with 95 % confidence intervals using a multivariate Poisson regression model to identify potential independent variables among meteorological factors and pollutants associated with either intracerebral hemorrhage or subarachnoid hemorrhage occurrence. Results We observed a negative correlation between intracerebral hemorrhage and mean temperature. In the multivariate Poisson model, particulate matter with an aerodynamic diameter < 10 μm showed positive correlations with intracerebral hemorrhage (relative risk, 1.09; 95 % confidence interval, 1.02 to 1.15; P = 0.012). In contrast, ozone correlated significantly with subarachnoid hemorrhage occurrence (relative risk, 1.32; 95 % confidence interval, 1.10 to 1.58; P = 0.003). Conclusions Our findings show the relationship between hemorrhagic stroke and meteorological parameters and pollutants under similar weather and environmental conditions in a small area. Among meteorological and pollutant variables, only higher particulate matter concentrations correlated independently with intracerebral hemorrhage occurrence, while only ozone was independently associated with subarachnoid hemorrhage occurrence. These findings suggest the possibility that there are pathogenic associations between hemorrhagic stroke and meteorological factors and pollutants.
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Affiliation(s)
- Myung-Hoon Han
- Department of Neurosurgery, Hanyang University Medical Center, 222 Haengdang-ro, Seoul, 133-792, South Korea
| | - Hyeong-Joong Yi
- Department of Neurosurgery, Hanyang University Medical Center, 222 Haengdang-ro, Seoul, 133-792, South Korea.
| | - Yong Ko
- Department of Neurosurgery, Hanyang University Medical Center, 222 Haengdang-ro, Seoul, 133-792, South Korea
| | - Young-Soo Kim
- Department of Neurosurgery, Hanyang University Medical Center, 222 Haengdang-ro, Seoul, 133-792, South Korea
| | - Young-Jun Lee
- Department of Radiology, Hanyang University Medical Center, Seoul, South Korea
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Rivera-Lara L, Kowalski RG, Schneider EB, Tamargo RJ, Nyquist P. Elevated relative risk of aneurysmal subarachnoid hemorrhage with colder weather in the mid-Atlantic region. J Clin Neurosci 2015; 22:1582-7. [PMID: 26149403 DOI: 10.1016/j.jocn.2015.03.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/27/2015] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
We have previously reported an increase of 0.6% in the relative risk of aneurysmal subarachnoid hemorrhage (aSAH) in response to every 1°F decrease in the maximum daily temperature (Tmax) in colder seasons from patients presenting to our regional tertiary care center. We hypothesized that this relationship would also be observed in the warmer summer months with ambient temperatures greater than 70°F. From prospectively collected incidence data for aSAH patients, we investigated absolute Tmax, average daily temperatures, intraday temperature ranges, and the variation of daily Tmax relative to 70°F to assess associations with aSAH incidence for patients admitted to our institution between 1991 and 2009 during the hottest months and days on which Tmax>70°F. For all days treated as a group, the mean Tmax (± standard deviation) was lower when aSAH occurred than when it did not (64.4±18.2°F versus 65.8±18.3°F; p=0.016). During summer months, the odds ratio (OR) of aSAH incidence increased with lower mean Tmax (OR 1.019; 95% confidence interval 1.001-1.037; p=0.043). The proportion of days with aSAH admissions was lower on hotter days than the proportion of days with no aSAH (96% versus 98%; p=0.006). aSAH were more likely to occur during the summer and on days with a temperature fluctuation less than 10°F (8% versus 4%; p=0.002). During the hottest months of the year in the mid-Atlantic region, colder maximum daily temperatures, a smaller heat burden above 70°F, and smaller intraday temperature fluctuations are associated with increased aSAH admissions in a similar manner to colder months. These findings support the hypothesis that aSAH incidence is more likely with drops in temperature, even in the warmer months.
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Affiliation(s)
- Lucia Rivera-Lara
- Department of Neurology, Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 455, Baltimore, MD 21287, USA.
| | - Robert G Kowalski
- Department of Neurology, Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 455, Baltimore, MD 21287, USA
| | - Eric B Schneider
- Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Rafael J Tamargo
- Department of Neurosurgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Paul Nyquist
- Department of Neurology, Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 455, Baltimore, MD 21287, USA
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Stienen MN, Smoll NR, Battaglia M, Schatlo B, Woernle CM, Fung C, Roethlisberger M, Daniel RT, Fathi AR, Fandino J, Hildebrandt G, Schaller K, Bijlenga P. Intracranial Aneurysm Rupture Is Predicted by Measures of Solar Activity. World Neurosurg 2015; 83:588-95. [DOI: 10.1016/j.wneu.2014.12.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 12/10/2014] [Indexed: 12/01/2022]
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Meteorological Variables Associated with Stroke. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:597106. [PMID: 27379326 PMCID: PMC4897103 DOI: 10.1155/2014/597106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 11/14/2014] [Accepted: 11/15/2014] [Indexed: 11/24/2022]
Abstract
To elucidate relationships between meteorological variables and incidence of stroke, we studied patients diagnosed with stroke after presenting to the emergency department (May 1, 2010–August 8, 2011). Patient demographics and medical data were reviewed retrospectively with regional meteorological data. Across 467 days, 134 stroke events were recorded on 114 days. On stroke days, maximum temperature (max T) and atmospheric pressure (AP) combined were a significant predictor of stroke (max T odds ratio (OR) = 1.014, 95% confidence interval (CI) = 1.003–1.026, and P = 0.04; AP: OR = 1.033, 95% CI = 0.997–1.071, and P = 0.02). When the patient could identify the hour of the stroke, average temperature (avg T) was significantly higher than nonstroke hours (18.2°C versus 16.16°C, P = 0.04). Daily fluctuations in AP and avg T also had significant effects on stroke incidence (AP: OR = 0.629, 95% CI = 0.512–0.773, and P = 0.0001; avg T OR = 1.1399, 95% CI = 1.218–606, and P = 0.0001). Patient age, stroke history, body mass index, ethnicity, and sex were further contributors to stroke risk. Temperature, atmospheric pressure, and certain physiological conditions likely play roles in weather-related stroke susceptibility. The mechanisms driving these associations are not fully understood.
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Lai PMR, Dasenbrock H, Du R. The association between meteorological parameters and aneurysmal subarachnoid hemorrhage: a nationwide analysis. PLoS One 2014; 9:e112961. [PMID: 25393630 PMCID: PMC4231088 DOI: 10.1371/journal.pone.0112961] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 10/16/2014] [Indexed: 02/05/2023] Open
Abstract
Prior research has suggested that regional weather patterns impact the risk of rupture of cerebral aneurysms, but the findings in the literature have been inconsistent. Furthermore, no nationwide analysis to date has examined the association between meteorological factors and the post-procedural outcomes of patients after the treatment for ruptured cerebral aneurysms. The purpose of this study was to use a nationwide sample to analyze the association between specific meteorological parameters—temperature, precipitation, sunlight, and humidity—and hospital admission rate for and outcome after aneurysmal subarachnoid hemorrhage. Patients were identified using the Nationwide Inpatient Sample (2001–2010): Those with an ICD-9 diagnosis code for subarachnoid hemorrhage and a procedural code for aneurysm repair were included. Climate data were obtained from the State of the Climate Report 2010 released by the National Climatic Data Center. Multivariate regression models were constructed to analyze the association between average state monthly temperature, precipitation, and percent possible sunlight, as well as relative morning humidity and both monthly hospital admission rate, adjusted for annual state population in millions, and in-hospital mortality. 16,970 admissions were included from 723 hospitals across 41 states. Decreased daily sunlight and lower relative humidity were associated with an increased rate of admission for ruptured cerebral aneurysms (p<0.001), but had no association with differential inpatient mortality. No significant changes in these observed associations were seen when multivariate analyses were constructed. This is the first nationwide study to suggest that decreased sunlight and lower relative humidity are associated with admission for ruptured cerebral aneurysms. While it has been postulated that external atmospheric factors may cause hormonal and homeostatic changes that impact the risk of rupture of cerebral aneurysms, additional research is needed to confirm and further understand these relationships.
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Affiliation(s)
- Pui Man Rosalind Lai
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Hormuzdiyar Dasenbrock
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Rose Du
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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Rosenbaum BP, Weil RJ. Aneurysmal subarachnoid hemorrhage: relationship to solar activity in the United States, 1988-2010. ASTROBIOLOGY 2014; 14:568-576. [PMID: 24979701 DOI: 10.1089/ast.2014.1138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Aneurysmal subarachnoid hemorrhage (SAH) is a common condition treated by neurosurgeons. The inherent variability in the incidence and presentation of ruptured cerebral aneurysms has been investigated in association with seasonality, circadian rhythm, lunar cycle, and climate factors. We aimed to identify an association between solar activity (solar flux and sunspots) and the incidence of aneurysmal SAH, all of which appear to behave in periodic fashions over long time periods. The Nationwide Inpatient Sample (NIS) provided longitudinal, retrospective data on patients hospitalized with SAH in the United States, from 1988 to 2010, who underwent aneurysmal clipping or coiling. Solar activity and SAH incidence data were modeled with the cosinor methodology and a 10-year periodic cycle length. The NIS database contained 32,281 matching hospitalizations from 1988 to 2010. The acrophase (time point in the cycle of highest amplitude) for solar flux and for sunspots were coincident. The acrophase for aneurysmal SAH incidence was out of phase with solar activity determined by non-overlapping 95% confidence intervals (CIs). Aneurysmal SAH incidence peaks appear to be delayed behind solar activity peaks by 64 months (95% CI; 56-73 months) when using a modeled 10-year periodic cycle. Solar activity (solar flux and sunspots) appears to be associated with the incidence of aneurysmal SAH. As solar activity reaches a relative maximum, the incidence of aneurysmal SAH reaches a relative minimum. These observations may help identify future trends in aneurysmal SAH on a population basis.
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Affiliation(s)
- Benjamin P Rosenbaum
- 1 Department of Neurosurgery, Neurological Institute, Cleveland Clinic , Cleveland, Ohio
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Meteorological influences on the incidence of aneurysmal subarachnoid hemorrhage - a single center study of 511 patients. PLoS One 2013; 8:e81621. [PMID: 24312565 PMCID: PMC3847045 DOI: 10.1371/journal.pone.0081621] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 10/20/2013] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To assess the potential meteorological influence on the incidence of aneurysmal subarachnoid hemorrhage (SAH). Previous studies used inhomogeneous patient groups, insufficient study periods or inappropriate statistics. PATIENTS AND METHODS We analyzed 511 SAH admissions between 2004 and 2012 for which aneurysmal rupture occurred within the Zurich region. The hourly meteorological parameters considered are: surface pressure, 2-m temperature, relative humidity and wind gusts, sunshine, and precipitation. For all parameters we investigate three complementary statistical measures: i) the time evolution from 5 days before to 5 days after the SAH occurrence; ii) the deviation from the 10-year monthly mean; and iii) the change relative to the parameter's value two days before SAH occurrence. The statistical significance of the results is determined using a Monte Carlo simulation combined with a re-sampling technique (1000×). RESULTS Regarding the meteorological parameters considered, no statistically significant signal could be found. The distributions of deviations relative to the climatology and of the changes during the two days prior to SAH events agree with the distributions for the randomly chosen days. The analysis was repeated separately for winter and summer to exclude compensating effects between the seasons. CONCLUSION By using high-quality meteorological data analyzed with a sophisticated and robust statistical method no clearly identifiable meteorological influence for the SAH events considered can be found. Further studies on the influence of the investigated parameters on SAH incidence seem redundant.
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Jeong TS, Park CW, Yoo CJ, Kim EY, Kim YB, Kim WK. Association between the daily temperature range and occurrence of spontaneous intracerebral hemorrhage. J Cerebrovasc Endovasc Neurosurg 2013; 15:152-7. [PMID: 24167793 PMCID: PMC3804651 DOI: 10.7461/jcen.2013.15.3.152] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/01/2013] [Accepted: 08/07/2013] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE We have observed, anecdotally, that the incidence of primary spontaneous intracerebral hemorrhage (sICH), as well as spontaneous subarachnoid hemorrhage, varies in accordance with seasonality and meteorological conditions. This retrospective single-hospital-based study aimed to determine the seasonality of sICH and the associations, if any, between the occurrence of sICH and meteorological parameters in Incheon city, which is a northwestern area of South Korea. METHODS Electronic hospital data on 708 consecutive patients admitted with primary sICH from January 2008 to December 2010 was reviewed. Traumatic and various secondary forms of ICHs were excluded. Average monthly admission numbers of sICH were analyzed, in relation with the local temperature, atmospheric pressure, humidity, and daily temperature range data. The relationships between the daily values of each parameter and daily admission numbers of sICH were investigated using a combination of correlation and time-series analyses. RESULTS No seasonal trend was observed in sICH-related admissions during the study period. Furthermore, no statistically significant correlation was detected between the daily sICH admission numbers and the meteorological parameters of temperature, atmospheric pressure and humidity. The daily temperature range tended to correlate with the number of daily sICH-related admissions (p = 0.097). CONCLUSION This study represents a comprehensive investigation of the association between various meteorological parameters and occurrence of spontaneous ICH. The results suggest that the daily temperature range may influence the risk of sICH.
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Affiliation(s)
- Tae Seok Jeong
- Department of Neurosurgery, Gil Medical Center, Gachon University, Incheon, Korea
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Impact of the moon on cerebral aneurysm rupture. Acta Neurochir (Wien) 2013; 155:1525-30. [PMID: 23702791 DOI: 10.1007/s00701-013-1740-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 04/22/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Several external and internal risk factors for cerebral aneurysm rupture have been identified to date. Recently, it has been reported that moon phases correlate with the incidence of aneurysmal subarachnoid hemorrhage (SAH), however, another author found no such association. Therefore, the present study investigates the influence of the lunar cycle on the incidence of aneurysmal rupture, the initial clinical presentation, and the amount of subarachnoid blood. METHODS Lunar phase and the particular day of the lunar cycle were correlated to the date of aneurysm rupture, aneurysm location, initial clinical presentation, and amount of subarachnoid blood assessed from CT scans of all patients treated for basal SAH in our department from 2003 to 2010. RESULTS We found no correlation between incidence of aneurysmal SAH, location of the aneurysm, initial clinical presentation, or amount of subarachnoid blood and the lunar cycle. CONCLUSIONS The moon influences neither the incidence of aneurysmal SAH nor the grade of initial neurological deterioration or amount of subarachnoid blood.
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Ishihara H, Kunitsugu I, Nomura S, Koizumi H, Yoneda H, Shirao S, Oka F, Morihiro Y, Yoshino H, Suzuki M. Seasonal variation in the incidence of aneurysmal subarachnoid hemorrhage associated with age and gender: 20-year results from the Yamaguchi cerebral aneurysm registry. Neuroepidemiology 2013; 41:7-12. [PMID: 23548679 DOI: 10.1159/000345247] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 10/10/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study was a cerebral aneurysm registry study conducted in a region with few climatic differences. Based on data collected for over 20 years, seasonal variations and characteristics of subarachnoid hemorrhage (SAH) due to ruptured aneurysms were analyzed. METHODS This study included 5,007 patients in the Yamaguchi Prefecture with aneurysmal SAH between 1986 and 2005. Incidence rates by month, sex, age, severity, and aneurysm site were analyzed. RESULTS In women, seasonal variation was observed, in particular among those aged ≥50 years. Among those aged 50-69 years, the highest incidence was in October, and the nadir was in June (peak-to-trough ratio = 1.72). At age ≥70 years, this was slightly different, with the highest incidence in December and the nadir in July (peak-to-trough ratio = 1.48). However, there was no seasonal variation in men overall; it was limited to elderly men at age ≥70 years, with the highest incidence in January and the nadir in July (peak-to-trough ratio = 2.9). Aneurysm site and severity showed no relationship with seasonal variation. CONCLUSION The present study shows seasonal variations in the onset of SAH. Seasonal variations in SAH differed depending on age and sex.
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Affiliation(s)
- Hideyuki Ishihara
- Department of Neurosurgery, Yamaguchi University School of Medicine, Yamaguchi 755-8505, Japan.
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Miranpuri AS, Aktüre E, Baggott CD, Miranpuri A, Uluç K, Güneş VE, Lin Y, Niemann DB, Başkaya MK. Demographic, circadian, and climatic factors in non-aneurysmal versus aneursymal subarachnoid hemorrhage. Clin Neurol Neurosurg 2013; 115:298-303. [DOI: 10.1016/j.clineuro.2012.05.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 04/17/2012] [Accepted: 05/25/2012] [Indexed: 12/01/2022]
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Macdonald RL. Whether subarachnoid hemorrhage depends on the weather? World Neurosurg 2012; 79:64-5. [PMID: 23103265 DOI: 10.1016/j.wneu.2012.10.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 10/23/2012] [Indexed: 11/28/2022]
Affiliation(s)
- R Loch Macdonald
- Division of Neurosurgery, St. Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
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Rønning P, Langmoen IA. Aneurysm rupture--does the weather matter? World Neurosurg 2012; 79:62-3. [PMID: 22858847 DOI: 10.1016/j.wneu.2012.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 07/26/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Pål Rønning
- Department of Neurosurgery, Oslo University Hospital and University of Oslo, Oslo, Norway.
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Gill RS, Hambridge HL, Schneider EB, Hanff T, Tamargo RJ, Nyquist P. Falling temperature and colder weather are associated with an increased risk of aneurysmal subarachnoid hemorrhage. World Neurosurg 2012; 79:136-42. [PMID: 22732514 DOI: 10.1016/j.wneu.2012.06.020] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 04/07/2012] [Accepted: 06/13/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To use weather data to predict increased incidence of aneurysmal subarachnoid hemorrhage (aSAH) at a large institution with an extensive referral network in response to falling temperatures. METHODS In a retrospective study, 1175 prospectively collected aSAH cases accrued over 18 years from one hospital were reviewed to determine if season, maximum ambient temperature (MAT), average relative humidity, and atmospheric pressure were related to incidence of aSAH at that institution on a given day. A Poisson regression model was used to assess daily risk of incident aSAH based on daily MAT and 1-day change in MAT. RESULTS A MAT decrease of 1°F from one day to the next was associated with a 0.6% increase in risk of aSAH (relative risk [RR]=1.006, P=0.016). The increased risk associated with MAT decrease from the previous day was especially strong for female patients (RR=1.008/°F, P=0.007) and drove the overall model, representing 72% of cases. In addition, warmer temperatures were associated with a decreased risk of aSAH; each 1°F increase in temperature compared with the previous day was associated with a 0.3% decrease in risk of aSAH (RR=0.997; P<0.001). CONCLUSIONS A 1-day decrease in temperature and colder daily temperatures were associated with an increased risk of incident aSAH at a single institution with a large referral network. These variables appeared to act synergistically and independently of season. These relationships were particularly predominant in the fall when the transition from warmer to colder temperatures occurred.
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Affiliation(s)
- Randeep S Gill
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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McDonald RJ, McDonald JS, Bida JP, Kallmes DF, Cloft HJ. Subarachnoid hemorrhage incidence in the United States does not vary with season or temperature. AJNR Am J Neuroradiol 2012; 33:1663-8. [PMID: 22576889 DOI: 10.3174/ajnr.a3059] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Previous studies have suggested seasonal variations in rates of spontaneous rupture of intracranial aneurysms, leading to potentially devastating SAH. In an effort to identify a seasonal effect, variation in SAH incidence and in-hospital mortality rates were examined as they relate to admission month, temperature, and climate using HCUP's Nationwide Inpatient Sample. MATERIALS AND METHODS Cases of nontraumatic SAH and subsequent in-hospital mortality were extracted from the 2001-2008 NIS and associated with month of occurrence, local average monthly temperatures, and USDA climate zone. Multivariate regression analysis was used to study how admission month, temperature, and climate affected SAH admission and mortality rates. RESULTS Among 57,663,486 hospital admissions from the 2001-2008 NIS, 52,379 cases of spontaneous SAH (ICD-9-CM 430) and 13,272 cases of subsequent in-hospital mortality were identified. SAH incidence and in-hospital mortality rates were not significantly correlated with a monthly/seasonal effect (incidence, χ(2) = 2.94, P = .99; mortality, χ(2) = 6.91, P = .81). However, SAH incidence significantly varied with climate (P < .0001, zones 11 and 7) but not with temperature (P = .1453), whereas average monthly temperature and climate had no significant correlation with in-hospital mortality (temperature, P = .3005; climate, P = .0863). CONCLUSIONS We identified no significant monthly or temperature-related effect in the incidence of SAH. Our data suggest that certain climate zones within the United States may be associated with significantly different SAH incidence, but the origins of these differences remain unclear and are probably unrelated to meteorologic variables.
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Affiliation(s)
- R J McDonald
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
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Cowperthwaite MC, Burnett MG. An analysis of admissions from 155 United States hospitals to determine the influence of weather on stroke incidence. J Clin Neurosci 2011; 18:618-23. [PMID: 21398128 DOI: 10.1016/j.jocn.2010.08.035] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 08/31/2010] [Accepted: 08/31/2010] [Indexed: 11/28/2022]
Abstract
Weather is the most frequently proposed factor driving apparent seasonal trends in stroke admissions. Here, we present the largest study of the association between weather and ischemic stroke in the USA to date. We consider admissions to 155 United States hospitals in 20 states during the five-year period from 2004 to 2008. The data set included 196,439 stroke admissions, which were classified as ischemic (n=98,930), hemorrhagic (n=18,960), or transient ischemic attack (n=78,549). Variations in stroke admissions were tested to determine if they tracked seasonal and transient weather patterns over the same time period. Using autocorrelation analyses, no significant seasonal changes in stroke admissions were observed over the study period. Using time-series analyses, no significant association was observed between any weather variable and any stroke subtype over the five-year study. This study suggests that seasonal associations between weather and stroke are highly confounded, and an association between weather and stroke is virtually non-existent. Therefore, previous studies reporting an association between specific weather patterns and stroke should be interpreted with caution.
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Affiliation(s)
- Matthew C Cowperthwaite
- NeuroTexas Institute at St. David's HealthCare, 1015 East 32nd Street, Suite 404, Austin, Texas 78705, USA.
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