Wang Xia, Cao Yongjun, Hong Daqing, Zheng Danni, Richtering Sarah, Sandset Else Charlotte, Leong Tzen Hugh, Arima Hisatomi, Islam Shariful, Salam Abdul, Anderson Craig, Robinson Thompson, Hackett Maree L
The George Institute for Global Health and Royal Prince Alfred Hospital, the University of Sydney, P.O. Box M201, Missenden Road, Sydney, NSW 2050, Australia.
Sydney Medical School, the University of Sydney, Sydney, NSW 2006, Australia.
Int J Environ Res Public Health. 2016 Jul 12;13(7):698. doi: 10.3390/ijerph13070698.
Biologically plausible associations exist between climatic conditions and stroke risk, but study results are inconsistent. We aimed to summarize current evidence on ambient temperature and overall stroke occurrence, and by age, sex, and variation of temperature. We performed a systematic literature search across MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and GEOBASE, from inception to 16 October 2015 to identify all population-based observational studies. Where possible, data were pooled for meta-analysis with Odds ratios (OR) and corresponding 95% confidence intervals (CI) by means of the random effects meta-analysis. We included 21 studies with a total of 476,511 patients. The data were varied as indicated by significant heterogeneity across studies for both ischemic stroke (IS) and intracerebral hemorrhage (ICH). Pooled OR (95% CI) in every 1 degree Celsius increase in ambient temperature was significant for ICH 0.97 (0.94-1.00), but not for IS 1.00 (0.99-1.01) and subarachnoid hemorrhage (SAH) 1.00 (0.98-1.01). Meta-analysis was not possible for the pre-specified subgroup analyses by age, sex, and variation of temperature. Change in temperature over the previous 24 h appeared to be more important than absolute temperature in relation to the risk of stroke, especially in relation to the risk of ICH. Older age appeared to increase vulnerability to low temperature for both IS and ICH. To conclude, this review shows that lower mean ambient temperature is significantly associated with the risk of ICH, but not with IS and SAH. Larger temperature changes were associated with higher stroke rates in the elderly.
气候条件与中风风险之间存在生物学上合理的关联，但研究结果并不一致。我们旨在总结当前关于环境温度与总体中风发生率以及按年龄、性别和温度变化的相关证据。我们对MEDLINE、Embase、PsycINFO、CINAHL、科学网和GEOBASE进行了系统的文献检索，检索时间从数据库建立至2015年10月16日，以确定所有基于人群的观察性研究。在可能的情况下，通过随机效应荟萃分析汇总数据以进行荟萃分析，得出比值比（OR）和相应的95%置信区间（CI）。我们纳入了21项研究，共有476,511名患者。数据存在差异，缺血性中风（IS）和脑出血（ICH）的研究间均存在显著异质性。环境温度每升高1摄氏度，ICH的合并OR（95%CI）为0.97（0.94 - 1.00）具有显著性，但IS为1.00（0.99 - 1.01）和蛛网膜下腔出血（SAH）为1.00（0.98 - 1.01）则无显著性。按年龄、性别和温度变化进行的预先指定亚组分析无法进行荟萃分析。过去24小时内的温度变化似乎比绝对温度与中风风险的关系更重要，尤其是与ICH风险的关系。年龄较大似乎会增加IS和ICH对低温的易感性。总之，本综述表明，较低的平均环境温度与ICH风险显著相关，但与IS和SAH无关。较大的温度变化与老年人较高的中风发生率相关。
