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气象因素对颅内动脉瘤性蛛网膜下腔出血发生率的影响——一项 511 例患者的单中心研究。

Meteorological influences on the incidence of aneurysmal subarachnoid hemorrhage - a single center study of 511 patients.

机构信息

University Hospital Zurich, Department of Neurosurgery, Zurich, Switzerland.

出版信息

PLoS One. 2013 Dec 2;8(12):e81621. doi: 10.1371/journal.pone.0081621. eCollection 2013.

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.

摘要

目的

评估气象因素对颅内动脉瘤性蛛网膜下腔出血(SAH)发病的潜在影响。既往研究使用的患者群体存在异质性、研究时间不足或统计方法不当。

患者与方法

我们分析了 2004 年至 2012 年间发生在苏黎世地区的 511 例 SAH 患者,其中动脉瘤破裂发生在入院后 5 天内。考虑的气象参数包括:地面气压、2 米气温、相对湿度和阵风、日照和降水。对于所有参数,我们研究了三种补充统计措施:i)SAH 发生前 5 天到后 5 天的时间演变;ii)与 10 年每月平均值的偏差;iii)与 SAH 发生前两天参数值的变化相对应。使用蒙特卡罗模拟和重采样技术(1000×)确定结果的统计学意义。

结果

关于所考虑的气象参数,未发现具有统计学意义的信号。相对气候的偏差分布和 SAH 事件前两天的变化分布与随机选择的天数的分布一致。为排除季节之间的补偿效应,分别对冬季和夏季进行了分析。

结论

使用高质量的气象数据和复杂稳健的统计方法进行分析,未发现所考虑的 SAH 事件存在明显可识别的气象影响。进一步研究调查参数对 SAH 发病率的影响似乎是多余的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a89/3847045/b84ee0cd9c03/pone.0081621.g001.jpg

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