Vrbova Linda, Crighton Eric J, Mamdani Muhammad, Moineddin Rahim, Upshur Ross E G
Department of Public Health Sciences, University of Toronto, Toronto, Canada.
Can J Cardiol. 2005 Aug;21(10):841-5.
Acute myocardial infarction (AMI) is a substantial cause of morbidity and mortality in Canada. Evidence suggests that the incidence and mortality of AMI increase in the winter. Determining the strength and nature of seasonality patterns in relation to age and sex may be helpful in health care planning.
To examine the seasonal patterns of AMI hospital admissions by age and sex, to assess the strength of the seasonal patterns and to examine the overall trends in admissions.
A retrospective population-based study was conducted to assess temporal patterns in 14 years of hospital admissions for AMI (from April 1, 1988, to March 31, 2002) in Ontario. Seasonality was assessed using the autoregression coefficient (R2Autoreg), and Fisher's Kappa and Bartlett's Kolmogorov-Smirnov tests.
There were 271,321 people in the cohort, of whom 63% (n = 171,546) were male and 37% (n = 99,775) were female. There was an increase in AMI admissions since 1988 that reached a plateau in 1992, which was attributable mostly to the increased rate in the oldest age groups (70 years and older), where admission rates more than doubled. An association between seasonality and AMI admissions was found in most age and sex groups, with men consistently exhibiting a stronger seasonality pattern. The greatest difference in the cohort, 2.5 per 100,000 per month (134 admissions), occurred between December and September (13.64 per 100,000 in September versus 16.14 per 100,000 in December).
AMI admissions show seasonality patterns, which are more pronounced in men. Although statistically significant, the seasonal differences are small in terms of absolute numbers, and are likely irrelevant in health care planning.
急性心肌梗死（AMI）是加拿大发病和死亡的主要原因。有证据表明，AMI的发病率和死亡率在冬季会上升。确定与年龄和性别相关的季节性模式的强度和性质可能有助于医疗保健规划。
按年龄和性别检查AMI住院的季节性模式，评估季节性模式的强度，并检查住院的总体趋势。
进行了一项基于人群的回顾性研究，以评估安大略省14年（从1988年4月1日至2002年3月31日）AMI住院的时间模式。使用自回归系数（R2Autoreg）、费舍尔卡方检验和巴特利特柯尔莫哥洛夫-斯米尔诺夫检验评估季节性。
该队列中有271,321人，其中63%（n = 171,546）为男性，37%（n = 99,775）为女性。自1988年以来，AMI住院人数有所增加，并于1992年达到平稳状态，这主要归因于最年长年龄组（70岁及以上）的住院率上升，该年龄组的住院率增加了一倍多。在大多数年龄和性别组中发现季节性与AMI住院之间存在关联，男性始终表现出更强的季节性模式。该队列中最大的差异为每月每10万人2.5例（134例住院），出现在12月和9月之间（9月为每10万人13.64例，12月为每10万人16.14例）。
AMI住院呈现季节性模式，男性更为明显。尽管在统计学上具有显著意义，但就绝对数量而言，季节性差异较小，在医疗保健规划中可能无关紧要。
