Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
Neuroepidemiology. 2009;32(1):53-60. doi: 10.1159/000170907. Epub 2008 Nov 12.
Seasonal variation in fatality caused by stroke was examined using 15 years of data from a stroke registry of a Japanese population.
Data were obtained from the Takashima Stroke Registry, which covers approximately 55,000 residents in central Japan. There were 1,650 registered cases of first-ever stroke between 1988 and 2002. 7- and 28-day fatality rates and 95% confidence intervals were calculated for winter, spring, summer and autumn. After adjusting for gender, age at onset and risk factors, the hazard ratios for fatal strokes in winter, spring and autumn were calculated, with summer serving as the reference.
For cerebral infarction, the highest 7- and 28-day fatality rates occurred during spring and winter, where they were more than double the rate during summer. The severest strokes were also more likely to occur during winter and spring. A high spring and winter hazard ratio for 28-day mortality was present in both lacunar and nonlacunar subtypes, in both genders and in subjects < 65 and > or = 65 years of age. No apparent seasonal pattern was observed for cerebral hemorrhage or subarachnoid hemorrhage. The spring and winter excess fatality persisted even after adjusting for age, gender and risk factors.
Patients who suffer an ischemic stroke during winter or spring have a poorer prognosis. Further investigation is needed to determine the factors that explain this excess risk.
使用日本人群中风登记处的 15 年数据来检查中风死亡率的季节性变化。
数据来自覆盖日本中部约 55000 名居民的高岛中风登记处。1988 年至 2002 年期间共登记了 1650 例首次发生的中风病例。计算了冬季、春季、夏季和秋季的 7 天和 28 天死亡率及其 95%置信区间。在调整了性别、发病年龄和危险因素后，计算了冬季、春季和秋季致命性中风的风险比，夏季为参照。
对于脑梗死，7 天和 28 天的死亡率最高发生在春季和冬季，是夏季的两倍多。最严重的中风也更可能发生在冬季和春季。腔隙性和非腔隙性亚型、男女以及<65 岁和≥65 岁的患者，28 天死亡率的春季和冬季风险比都很高。脑出血或蛛网膜下腔出血没有明显的季节性模式。即使在调整了年龄、性别和危险因素后，冬季和春季的超额死亡率仍然存在。
在冬季或春季发生缺血性中风的患者预后较差。需要进一步调查以确定解释这种风险增加的因素。
