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Danh N, Ho C, Ford E, Zhang J, Hong H, Reid C, Xu D. Association between ambient temperature and stroke risk in high-risk populations: a systematic review. Front Neurol 2024; 14:1323224. [PMID: 38259643 PMCID: PMC10801432 DOI: 10.3389/fneur.2023.1323224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Background Significant associations exist between ambient temperature and stroke risk, but results in high cardiovascular risk populations are lacking. This systemic review summarised current evidence on ambient temperature and overall stroke risk in a high cardiovascular risk population. Methods We performed a systematic literature search across MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and GEOBASE, from inception to 3 July 2023, to identify all population-based studies. Eligible studies screened by independent reviewers recruited individuals aged 18 years and over, where minimum 80% of participants had a high cerebral vascular disease (CVD) risk profile. The primary outcomes are stroke morbidity and mortality, while the secondary outcomes are morbidity and mortality of ischaemic stroke (IS), intracranial cerebral haemorrhage (ICH), and subarachnoid haemorrhage (SH). Results The database searches identified 9,025 articles. After removing duplicates, 7,647 articles were screened in title and abstract to identify 380 articles for full-text screening. After the full-text screening of 380 articles by two independent reviewers, 23 articles were included in the review. Conclusion The evidence for an association between ambient temperature and stroke incidence is that lower temperatures were more likely to increase morbidity and mortality risk of both haemorrhagic and ischaemic stroke in older people. Conversely, higher ambient temperature is significantly associated with intracranial haemorrhage risk, but decreased risk with IS. Higher and lower ambient temperatures consistently increase stroke risks in patients with comorbidities of congestive heart failure and dyslipidaemia. This evidence implies the need to establish clinical guidelines for preventive intervention in patients with high stroke risks during extreme ambient temperatures.
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Affiliation(s)
- Nathan Danh
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Chau Ho
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Emily Ford
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Jian Zhang
- Department of Neurology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hua Hong
- Department of Neurology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Christopher Reid
- Department of Neurology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dan Xu
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Department of Neurology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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2
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Folyovich A, Mátis R, Biczó D, Pálosi M, Béres-Molnár AK, Al-Muhanna N, Jarecsny T, Dudás E, Jánoska D, Toldi G, Páldy A. High average daily temperature in summer and the incidence of thrombolytic treatment for acute ischemic stroke. L'ENCEPHALE 2023:S0013-7006(23)00202-6. [PMID: 38040506 DOI: 10.1016/j.encep.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Meteorological factors can increase stroke risk; however, their impact is not precisely understood. Heat waves during summer increase total mortality. Therefore, we hypothesized that the average daily temperature in summer may correlate with the incidence of thrombolytic treatment for acute ischemic stroke in Budapest and Pest County, Hungary. METHODS We analyzed the relationship between the average daily temperature in summer months and the daily number of thrombolytic treatments (TT) performed with the indication of acute ischemic stroke between 1st June and 31st August each year from 2007 to 2016. The analysis was also performed after the omission of the data of the last day of the months due to possible psychosocial impact reported in our previous study. Spearman's correlation was used for statistical analysis. RESULTS No significant correlation was found between the average summer daily temperature and the number of TT in the entire sample of the 10-year period. When omitting the data of the last day of each month, positive correlations were suspected in 2014 (r=0.225, P=0.034) and 2015 (r=0.276, P=0.009). CONCLUSION Our findings did not confirm an association between the average daily temperature in summer and the daily number of TT throughout the examined 10-year period. However, importantly, in 2014 and 2015, the years with the highest average daily temperatures in this period, a positive correlation was found. The level of correlation is modest, indicating that risk factors, both meteorological and non-meteorological, other than the average temperature, play equally important roles in determining the incidence of thrombolytic treatment for acute ischemic stroke on the population level.
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Affiliation(s)
- András Folyovich
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Réka Mátis
- Faculty of Public Governance and International Studies, University of Public Service, Budapest, Hungary
| | | | - Mihály Pálosi
- National Institute of Health Insurance Fund Management, Budapest, Hungary
| | | | - Nadim Al-Muhanna
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Tamás Jarecsny
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Eszter Dudás
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Dorottya Jánoska
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Gergely Toldi
- Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - Anna Páldy
- National Public Health Center, Budapest, Hungary
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3
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Yang M, Yoo H, Kim SY, Kwon O, Nam MW, Pan KH, Kang MY. Occupational Risk Factors for Stroke: A Comprehensive Review. J Stroke 2023; 25:327-337. [PMID: 37813670 PMCID: PMC10574301 DOI: 10.5853/jos.2023.01011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 10/11/2023] Open
Abstract
For primary prevention, it is important for public health and clinical medicine to identify and characterize modifiable risk factors of stroke. In existing literature, the impact of occupational variables on ischemic and hemorrhagic stroke has been extensively studied. This review summarizes the available data on the significance of occupational variables in stroke. The results of this review suggest that there is sufficient evidence for the relationship between increased risk of stroke and job stress, working in extreme temperatures, long working hours, and/or shift work. The association between long working hours and occupational exposure to noise and chemicals remains inconclusive although several studies have reported this finding. This review will act as a step toward future research and provide information that may serve as a baseline for developing targeted interventions to prevent stroke in the working population.
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Affiliation(s)
- Munyoung Yang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyoungseob Yoo
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seo-Young Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ohwi Kwon
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Woo Nam
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Kwang Hyun Pan
- Department of Neurology, Anam Hospital, Korea University, Seoul, Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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4
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Wang P, Cheng S, Song W, Li Y, Liu J, Zhao Q, Luo S. Daily Meteorological Parameters Influence the Risk of Intracerebral Hemorrhage in a Subtropical Monsoon Basin Climate. Risk Manag Healthc Policy 2021; 14:4833-4841. [PMID: 34916860 PMCID: PMC8667755 DOI: 10.2147/rmhp.s331314] [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: 09/14/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Purpose The correlation between meteorological parameters and intracerebral hemorrhage (ICH) occurrence is controversial. Our research explored the effect of daily meteorological parameters on ICH risk in a subtropical monsoon basin climate. Methods We retrospectively analyzed patients with ICH in a teaching hospital. Daily meteorological parameters including temperature (TEM), atmospheric pressure (PRE), relative humidity (RHU), and sunshine duration (SSD) were collected, with the diurnal variation (daily maximum minus minimum) and day-to-day variation (average of the day minus the previous day) calculated to represent their fluctuation. We adopted a time-stratified case-crossover approach and selected conditional logistic regression to explore the effect of meteorological parameters on ICH risk. The influence of monthly mean temperature proceeded via stratified analysis. Air pollutants were gathered as covariates. Results Our study included 1052 eligible cases with ICH. In a single-factor model, the risk of ICH decreased by 5.9% (P<0.001) for each 1°C higher of the daily mean TEM, and the risk increased by 2.4% (P=0.002) for each 1hPa higher of the daily mean PRE. Prolongation of daily SSD inhibited the risk of ICH, and OR was 0.959 (P=0.007). The risk was raised by 7.5% (P=0.0496) with a 1°C increment of day-to-day variation of TEM. In a two-factor model, the effect of daily mean TEM or daily SSD on ICH risk was still statistically significant after adjusting another factor. The influence of meteorological parameters on ICH risk continued in cold months but disappeared in warm months after stratified analysis. Conclusion This research indicates daily TEM and SSD had an inverse correlation to ICH risk in a subtropical monsoon basin climate. They were independent when adjusted by another factor. Daily PRE and day-to-day TEM variation were positively related to ICH risk. The correlation of daily meteorological factors on ICH risk was affected by the monthly thermal background.
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Affiliation(s)
- Peng Wang
- Department of Neurosurgery, Chengdu Fifth People's Hospital/Affiliated Chengdu No.5 People's Hospital of Chengdu University of TCM, Chengdu, People's Republic of China
| | - Shuwen Cheng
- Department of Neurosurgery, Chengdu Fifth People's Hospital/Affiliated Chengdu No.5 People's Hospital of Chengdu University of TCM, Chengdu, People's Republic of China
| | - Weizheng Song
- Department of Neurosurgery, Chengdu Fifth People's Hospital/Affiliated Chengdu No.5 People's Hospital of Chengdu University of TCM, Chengdu, People's Republic of China
| | - Yaxin Li
- West China Fourth Hospital/West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Jia Liu
- Department of Neurosurgery, Chengdu Fifth People's Hospital/Affiliated Chengdu No.5 People's Hospital of Chengdu University of TCM, Chengdu, People's Republic of China
| | - Qiang Zhao
- Department of Neurosurgery, Chengdu Fifth People's Hospital/Affiliated Chengdu No.5 People's Hospital of Chengdu University of TCM, Chengdu, People's Republic of China
| | - Shuang Luo
- Department of Neurosurgery, Chengdu Fifth People's Hospital/Affiliated Chengdu No.5 People's Hospital of Chengdu University of TCM, Chengdu, People's Republic of China
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Zaręba K, Lasek-Bal A, Student S. The Influence of Selected Meteorological Factors on the Prevalence and Course of Stroke. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111216. [PMID: 34833434 PMCID: PMC8619234 DOI: 10.3390/medicina57111216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
Background: The objective of this study was to evaluate the impact of weather factors on stroke parameters. Methods: This retrospective study analyzed the records of stroke patients concerning the influence of meteorological conditions and moon phases on stroke parameters. Results: The study group consisted of 402 patients aged between 20 and 102; women constituted 49.8% of the subjects. Ischaemic stroke was diagnosed in 90.5% of patients and hemorrhagic stroke was diagnosed in 9.5% of patients. The highest number of hospitalizations due to stroke was observed in January (48 events); the lowest number was observed in July (23 events). There was no statistically significant correlation between the meteorological parameters on the day of onset and the preceding day of stroke and the neurological status (NIHSS) of patients. Mean air temperature on the day of stroke and the day preceding stroke was significantly lower in the group of patients discharged with a very good functional status (≤2 points in modified Rankin scale (mRS)) compared to the patients with a bad functional status (>2 points in mRS); respectively: 7.98 ± 8.01 vs. 9.63 ± 7.78; p = 0.041 and 8.13 ± 7.72 vs. 9.70 ± 7.50; p = 0.048). Humidity above 75% on the day of stroke was found to be a factor for excellent functional state (RR 1.61; p = 0.016). The total anterior circulation infarcts (in comparison with stroke in the other localization) were more frequent (70%) during a third quarter moon (p = 0.011). The following parameters had a significant influence on the number of stroke cases in relation to autumn having the lowest number of onsets: mean temperature (OR 1.019 95% CI 1.014–1.024, p < 0.000), humidity (OR 1.028, CI 1.023–1.034, p < 0.0001), wind speed (OR 0.923, 95% CI 0.909–0.937, p < 0.0001), insolation (OR 0.885, 95% CI 0.869–0.902, p < 0.0001), precipitation (OR 0.914, 95% CI 0.884–0.946, p < 0.0001). Conclusion: Air humidity and air temperature on the day of stroke onset as well as air temperature on the day preceding stroke are important for the functional status of patients in the acute disease period. A combination of the following meteorological parameters: lowered mean temperature and low sunshine, high humidity and high wind speed all increase the risk of stroke during the winter period. High humidity combined with high precipitation, low wind speed and low sunshine in the autumn period are associated with the lowest stroke incidence risk. A possible relationship between phases of the moon and the incidence requires further investigation.
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Affiliation(s)
| | - Anetta Lasek-Bal
- Medical University of Silesia, 40-055 Katowice, Poland
- Department of Neurology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland
| | - Sebastian Student
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
- Biotechnology Center, Silesian University of Technology, 44-100 Gliwice, Poland
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6
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Alghamdi SAM, Aldriweesh MA, Al Bdah BA, Alhasson MA, Alsaif SA, Alluhidan WA, Almutairi FM, Alskaini MA, Alotaibi N, Al Khathaami AM. Stroke Seasonality and Weather Association in a Middle East Country: A Single Tertiary Center Experience. Front Neurol 2021; 12:707420. [PMID: 34733227 PMCID: PMC8558216 DOI: 10.3389/fneur.2021.707420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/16/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Stroke is a medical condition that leads to major disability and mortality worldwide. Some evidence suggests that weather and seasonal variations could have an impact on stroke incidence and outcome. However, the current evidence is inconclusive. Therefore, this study examines the seasonal variations and meteorological influences on stroke incidence and outcome in the largest city in Saudi Arabia. Methods: From February 2016 to July 2019, we retrospectively reviewed data from all patients with acute ischemic (AIS) or hemorrhagic stroke (HS) admitted to the stroke unit in a tertiary academic center in Saudi Arabia. The corresponding daily meteorological data were obtained for the same period. We considered the months from November to March as the cold season and April to October as the hot season. Results: The final cohort included 1,271 stroke patients; 60.89% (n = 774) cases occurred in the hot season, while 39.1% (n = 497) in the cold season. Males accounted for 69.6% (n = 884) of the cases. The proportion of ischemic stroke was 83.2% [hot season 83.9% (n = 649) vs. cold season 82.3% (n = 409)]. We found no statistically significant difference between seasons (hot or cold) in stroke incidence, severity [National Institutes of Health Stroke Scale (NIHSS)], hospital course (pneumonia, thromboembolism, intensive care stay, or length of stay), or outcome [modified Rankin scale (mRS) on discharge and death]. Conclusions: In Riyadh, Saudi Arabia, our study found no impact of weather or seasonal variations on stroke incidence, hospital course, or outcomes. However, our findings warrant further research in different country regions.
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Affiliation(s)
- Saeed A M Alghamdi
- Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Mohammed A Aldriweesh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Bayan A Al Bdah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Muath A Alhasson
- Unaizah College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Sultan A Alsaif
- College of Medicine, Almaarefa University, Riyadh, Saudi Arabia
| | - Waleed A Alluhidan
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Faisal M Almutairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed A Alskaini
- Department of Neurology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Naser Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ali M Al Khathaami
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
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7
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Dynamic Changes and Temporal Association with Ambient Temperatures: Nonlinear Analyses of Stroke Events from a National Health Insurance Database. J Clin Med 2021; 10:jcm10215041. [PMID: 34768561 PMCID: PMC8584505 DOI: 10.3390/jcm10215041] [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: 07/27/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background: The associations between ambient temperatures and stroke are still uncertain, although they have been widely studied. Furthermore, the impact of latitudes or climate zones on these associations is still controversial. The Tropic of Cancer passes through the middle of Taiwan and divides it into subtropical and tropical areas. Therefore, the Taiwan National Health Insurance Database can be used to study the influence of latitudes on the association between ambient temperature and stroke events. Methods: In this study, we retrieved daily stroke events from 2010 to 2015 in the New Taipei and Taipei Cities (the subtropical areas) and Kaohsiung City (the tropical area) from the National Health Insurance Research Database. Overall, 70,338 and 125,163 stroke events, including ischemic stroke and intracerebral hemorrhage, in Kaohsiung City and the Taipei Area were retrieved from the database, respectively. We also collected daily mean temperatures from the Taipei and Kaohsiung weather stations during the same period. The data were decomposed by ensemble empirical mode decomposition (EEMD) into several intrinsic mode functions (IMFs). There were consistent 6-period IMFs with intervals around 360 days in most decomposed data. Spearman’s rank correlation test showed moderate-to-strong correlations between the relevant IMFs of daily temperatures and events of stroke in both areas, which were higher in the northern area compared with those in the southern area. Conclusions: EEMD is a useful tool to demonstrate the regularity of stroke events and their associations with dynamic changes of the ambient temperature. Our results clearly demonstrate the temporal association between the ambient temperature and daily events of ischemic stroke and intracranial hemorrhage. It will contribute to planning a healthcare system for stroke seasonally. Further well-designed prospective studies are needed to elucidate the meaning of these associations.
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Khan K, Tanaka-Mizuno S, Turin TC, Takashima N, Kadota A, Ueshima H, Miura K, Kita Y. Relationship of Ambient Temperature Parameters to Stroke Incidence in a Japanese Population - Takashima Stroke Registry, Japan, 1988-2010. Circ J 2021; 85:2215-2221. [PMID: 34321376 DOI: 10.1253/circj.cj-21-0325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Using a population-based stroke registry system, we evaluated the relationship between ambient temperature parameters and stroke incidence in a Japanese population.Methods and Results:We analyzed data from the Takashima Stroke Registry, which records all stroke occurrences in Takashima City, Japan. The study period of 8,401 days was divided into quintiles of daily weather parameters, and the middle quintile was used as the reference category. Incidence rates (IR per 100,000 person-years) were calculated across the quintiles. Poisson regression analysis was used to calculate the effect of temperature parameters on stroke incidence. There were 2,405 first-ever strokes (1,294 men), including 1,625 ischemic, 545 cerebral hemorrhages, 213 subarachnoid hemorrhages, and 22 unclassified strokes. The stroke IR was higher in the middle quintile of average temperature, 357.3 (328.4-388.8), and for other parameters. After adjustment for age and sex, for all stroke, the incidence rate ratio (IRR) in the highest (Q5: IRR 0.81, 95% confidence interval (CI) 0.71-0.92) and the second-highest (Q4: IRR 0.80, 95% CI 0.71-0.91) quintile was lower than that in the middle quintile (Q3: Reference). Analogous results were observed for the minimum, maximum, and lag-days temperatures, also in the subtypes and across ≥65 years of age, also in females. CONCLUSIONS Higher temperatures, irrespective of the parameter (average, minimum, or maximum), had a protective effect against stroke occurrence in Japan.
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Affiliation(s)
- Kawser Khan
- Department of Public Health, Shiga University of Medical Science.,National Heart Foundation Hospital and Research Institute
| | - Sachiko Tanaka-Mizuno
- Department of Medical Statistics, Shiga University of Medical Science.,Department of Digital Health and Epidemiology, Kyoto University
| | - Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science.,Department of Public Health, Kindai University, Faculty of Medicine
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science.,NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science.,NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Yoshikuni Kita
- Department of Public Health, Shiga University of Medical Science.,Tsuruga Nursing University
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9
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Moscote-Salazar LR, Agrawal A. Re: Meteorological Factors and Seasonal Stroke Rates. J Stroke Cerebrovasc Dis 2020; 29:104766. [PMID: 32171624 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 02/13/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh (India)
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10
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Stroke to Dementia Associated with Environmental Risks-A Semi-Markov Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061944. [PMID: 32188138 PMCID: PMC7143936 DOI: 10.3390/ijerph17061944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Most stroke cases lead to serious mental and physical disabilities, such as dementia and sensory impairment. Chronic diseases are contributory risk factors for stroke. However, few studies considered the transition behaviors of stroke to dementia associated with chronic diseases and environmental risks. OBJECTIVE This study aims to develop a prognosis model to address the issue of stroke transitioning to dementia associated with environmental risks. DESIGN This cohort study used the data from the National Health Insurance Research Database in Taiwan. SETTING Healthcare data were obtained from more than 25 million enrollees and covered over 99% of Taiwan's entire population. PARTICIPANTS In this study, 10,627 stroke patients diagnosed from 2000 to 2010 in Taiwan were surveyed. METHODS A Cox regression model and corresponding semi-Markov process were constructed to evaluate the influence of risk factors on stroke, corresponding dementia, and their transition behaviors. MAIN OUTCOME MEASURE Relative risk and sojourn time were the main outcome measure. RESULTS Multivariate analysis showed that certain environmental risks, medication, and rehabilitation factors highly influenced the transition of stroke from a chronic disease to dementia. This study also highlighted the high-risk populations of stroke patients against the environmental risk factors; the males below 65 years old were the most sensitive population. CONCLUSION Experiments showed that the proposed semi-Markovian model outperformed other benchmark diagnosis algorithms (i.e., linear regression, decision tree, random forest, and support vector machine), with a high R2 of 90%. The proposed model also facilitated an accurate prognosis on the transition time of stroke from chronic diseases to dementias against environmental risks and rehabilitation factors.
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The Association between Air Temperature and Mortality in Two Brazilian Health Regions. CLIMATE 2020. [DOI: 10.3390/cli8010016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Air temperature, both cold and hot, has impacts on mortality and morbidities, which are exacerbated by poor health service and protection responses, particularly in under-developed countries. This study was designed to analyze the effects of air temperature on the risk of deaths for all and specific causes in two regions of Brazil (Florianopolis and Recife), between 2005 and 2014. The association between temperature and mortality was performed through the fitting of a quasi-Poisson non-linear lag distributed model. The association between air temperature and mortality was identified for both regions. The results showed that temperature exerted influence on both general mortality indicators and specific causes, with hot and cold temperatures bringing different impacts to the studied regions. Cerebrovascular and cardiovascular deaths were more sensitive to cold temperatures for Florianopolis and Recife, respectively. Based on the application of the very-well documented state-of-the-art methodology, it was possible to conclude that there was evidence that extreme air temperature influenced general and specific deaths. These results highlighted the importance of consolidating evidence and research in tropical countries such as Brazil as a way of understanding climate change and its impacts on health indicators.
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Royé D, Zarrabeitia MT, Riancho J, Santurtún A. A time series analysis of the relationship between apparent temperature, air pollutants and ischemic stroke in Madrid, Spain. ENVIRONMENTAL RESEARCH 2019; 173:349-358. [PMID: 30953949 DOI: 10.1016/j.envres.2019.03.065] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/23/2019] [Accepted: 03/25/2019] [Indexed: 05/04/2023]
Abstract
The understanding of the role of environment on the pathogenesis of stroke is gaining importance in the context of climate change. This study analyzes the temporal pattern of ischemic stroke (IS) in Madrid, Spain, during a 13-year period (2001-2013), and the relationship between ischemic stroke (admissions and deaths) incidence and environmental factors on a daily scale by using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of air pollutants and Apparent Temperature (AT), a biometeorological index which represents human thermal comfort on IS, a lag non-linear model was fitted in a generalized additive model. The mortality rate followed a downward trend over the studied period, however admission rates progressively increased. Our results show that both increases and decreases in AT had a marked relationship with IS deaths, while hospital admissions were only associated with low AT. When analyzing the cumulative effects (for lag 0-14 days), with an AT of 1.7 °C (percentile 5%) a RR of 1.20 (95% CI, 1.05-1.37) for IS mortality and a RR of 1.09 (95% CI, 0.91-1.29) for morbidity is estimated. Concerning gender differences, men show higher risks of mortality in low temperatures and women in high temperatures. No significant relationship was found between air pollutant concentrations and IS morbi-mortality, but this result must be interpreted with caution, since there are strong spatial fluctuations of the former between nearby geographical areas that make it difficult to perform correlation analyses.
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Affiliation(s)
- Dominic Royé
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain; Department of Geography, University of Porto, Porto, Portugal; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - María T Zarrabeitia
- Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, Santander, Spain
| | - Javier Riancho
- Department of Neurology, Hospital Sierrallana-Instituto de Investigación Sanitaria (IDIVAL), Centro Investigación Biomédica en Red Enfermedades (CIBERNED), Santander, Spain
| | - Ana Santurtún
- Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, Santander, Spain.
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Polcaro-Pichet S, Kosatsky T, Potter BJ, Bilodeau-Bertrand M, Auger N. Effects of cold temperature and snowfall on stroke mortality: A case-crossover analysis. ENVIRONMENT INTERNATIONAL 2019; 126:89-95. [PMID: 30784804 DOI: 10.1016/j.envint.2019.02.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND We sought to determine if cold temperature and snowfall are independently associated with stroke mortality, and whether effects differ between hemorrhagic and ischemic stroke. MATERIALS AND METHODS We conducted a case-crossover study of 13,201 stroke deaths utilizing weather records between the months of November and April for Quebec, Canada from 1981 to 2015. We compared exposure to cold temperature and snowfall with controls days when stroke death did not occur. We computed odds ratios (OR) and 95% confidence intervals (CI) for the association of minimum temperature and duration of snowfall with stroke, adjusted for change in barometric pressure and relative humidity. RESULTS The likelihood of mortality the day following exposure to cold temperature was elevated for hemorrhagic stroke in men, independent of snowfall. Relative to 0 °C, a temperature of -20 °C was associated with 1.17 times the odds of hemorrhagic stroke death (95% CI 1.04-1.32). An independent effect of snowfall was also present in men, with 12 h of snowfall associated with 1.12 times the odds of hemorrhagic stroke death (95% CI 1.00-1.24) compared with no snowfall. There was no evidence of an increased risk in women. Cold temperature and snowfall were not associated with ischemic stroke death in either men or women. CONCLUSION Our results suggest that cold temperature and snowfall are independent risk factors for death from hemorrhagic stroke in men. These findings imply that interventions to prevent fatal hemorrhagic stroke during winter should include both cold temperature exposure and snowfall in men.
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Affiliation(s)
- Sara Polcaro-Pichet
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Tom Kosatsky
- National Collaborating Centre for Environmental Health, British Columbia Centre for Disease Control, Vancouver, Canada
| | - Brian J Potter
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Department of Cardiology, University of Montreal Hospital Center, Montreal, Quebec, Canada
| | | | - Nathalie Auger
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.
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14
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Seasonal variation in the occurrence of ischemic stroke: A meta-analysis. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2019; 41:2113-2130. [PMID: 30848411 DOI: 10.1007/s10653-019-00265-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 02/11/2019] [Indexed: 02/05/2023]
Abstract
Stroke was demonstrated to correlate with seasonal variation. However, the relevant studies were incongruous. To better understand the rules of seasonal impact on ischemic stroke (IS) patients, we performed this meta-analysis. We systematically searched relevant observational studies in Pubmed, Web of science and Embase from January 1, 1980, to November 1, 2017, in English. Patients included in this study were adults who suffered from IS. Stata version 12.0 software was used to pool useful data and calculate incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). We also performed heterogeneity and sensitivity analyses and evaluated publication bias. Thirty-three observational studies involving 234,196 participants were incorporated into the meta-analysis. Summer and December were regarded as reference, respectively. The IRRs were calculated showing: IRRWinter 1.05 (95% CI 1.04-1.07), IRRAutumn 1.03 (95% CI 1.02-1.04), IRRSpring 1.02 (95% CI 1.01-1.03). No obvious difference existed among 12 months. Stratified analyses on Köppen classification were also conducted. Between-study heterogeneity was discovered; however, predefined stratified analyses and meta-regression could not reduce this heterogeneity. Our meta-analysis has revealed very little seasonal variation in the overall study. Both cold and hot months may be high risky for IS after stratified by Köppen Climate Classification. Thus, a rationale to environmental setting of risky patient management could be provided. More studies with specific assessments are warranted for further comprehensive investigation.
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Shartova N, Shaposhnikov D, Konstantinov P, Revich B. Сardiovascular mortality during heat waves in temperate climate: an association with bioclimatic indices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:522-534. [PMID: 30019603 DOI: 10.1080/09603123.2018.1495322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/27/2018] [Indexed: 06/08/2023]
Abstract
The authors studied the relative predictive powers of several bioclimatic indices as predictors of population mortality during heat waves. Daily mean and maximum values of air temperature, Humidex, apparent, and physiological equivalent temperatures (PETs) were examined. The numbers of daily deaths and daily meteorological data in Rostov-on-Don (southern Russia) were used. The study period spanned April-September between 1999 and 2011. The eight selected bioclimatic indices were used to identify heat waves and calculate the expected increases in mortality during such events from Poisson generalized linear model of daily death counts. All of the bioclimatic indices considered were positively and significantly associated with mortality during heat waves. The best predictor was chosen from a set of similar models by maximization of relative mortality risk estimates. Having compared the relative increases and their significance levels in several cause- and age-specific mortality rates, the authors concluded that PET was the most powerful predictor.
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Affiliation(s)
- Natalia Shartova
- a Faculty of Geography , Lomonosov Moscow State University , Moscow , Russia
| | - Dmitry Shaposhnikov
- b Institute of Economic Forecasting, Russian Academy of Sciences, Environmental Health Laboratory , Moscow , Russia
| | - Pavel Konstantinov
- a Faculty of Geography , Lomonosov Moscow State University , Moscow , Russia
| | - Boris Revich
- b Institute of Economic Forecasting, Russian Academy of Sciences, Environmental Health Laboratory , Moscow , Russia
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Guan W, Clay SJ, Sloan GJ, Pretlow LG. Effects of Barometric Pressure and Temperature on Acute Ischemic Stroke Hospitalization in Augusta, GA. Transl Stroke Res 2018; 10:10.1007/s12975-018-0640-0. [PMID: 29936653 DOI: 10.1007/s12975-018-0640-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/24/2018] [Accepted: 06/12/2018] [Indexed: 01/12/2023]
Abstract
Several studies worldwide have demonstrated significant relationships between meteorological parameters and stroke events. However, authors often reported discordant effects of both barometric pressure and air temperature on stroke occurrence. The present study investigated whether there was an association between weather parameters (barometric pressure and temperature) and ischemic stroke hospitalization. The aim of the study was to find out whether daily barometric pressure may be used as a prognostic variable to evaluate the workload change of a neurological intensive care unit. We conducted a retrospective review study in which we collected the independent (barometric pressure and temperature) and dependent variables (stroke hospitalization) every 24 h for the periods 10/1/2016-4/30/2017 at Augusta University Medical Center of Augusta, GA. We analyzed the data with zero-inflated Poisson model to assess the relationship between the barometric pressure, temperature, and daily stroke hospitalization. The results showed that there was a significantly correlation between daily barometric pressure variation and daily stroke hospitalization, especially on elder male patients (≥ 65). Stroke events were more likely to occur in the patients with risk factors than in those without risk factors when exposed to barometric pressure and temperature changes. Decreased barometric pressure and increased temperature were associated with increased daily stroke hospitalization. Furthermore, there was a potential delayed effect of increased stroke events after cold temperature exposure. Barometric pressure and temperature changes over the preceding 24 h are associated with daily stroke hospitalization. These findings may enhance our understanding of relationship between stroke and weather and maybe used in the development of public health strategies to minimize the weather-related stroke risk.
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Affiliation(s)
- Weihua Guan
- Master of Science-Clinical Laboratory Science Program, College of Allied Health Sciences, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.
| | - Sandra J Clay
- Augusta University Medical Center, 1120 15th street, Augusta, GA, 30912, USA
| | - Gloria J Sloan
- Department of Medical Laboratory, Imaging and Radiological Science, College of Allied Health Science, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Lester G Pretlow
- Department of Medical Laboratory, Imaging and Radiological Science, College of Allied Health Science, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
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