Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
Sci Total Environ. 2017 Feb 15;580:307-315. doi: 10.1016/j.scitotenv.2016.11.093. Epub 2016 Dec 21.
Stroke is a main cause of death and public health burden in China. The evidence on the burden of different strokes attack attribute to ambient temperature in China is limited. This study aimed to show the characteristics of stroke attack and the attributable risk due to temperature based on hospital admission data in Guangzhou, one of the most developed cities in China.
From January 1, 2013 to December 31, 2015, 104,432 stroke hospitalizations in Guangzhou residents from 67 hospitals for stroke sentinel surveillance were registered. Characteristics of hospital admissions by gender, age group, calendar year and stroke subtype were analyzed, and distributed lag non-linear models were applied to evaluate the effects of temperature on stroke attack admissions.
Stroke attack admissions increased from 31,851 to 36,755 through 2013 to 2015, increasing by 15.4%. An increasing trend in the risk of stroke attack with age was observed, irrespectively of stroke subtype and calendar year. People with hypertension were more likely to have an associated stroke than people without that. The effects of cold temperature on attack admissions for CBI and ICH strokes were significant. Overall, the percentages of CBI and ICH attack admissions attribute to cold temperature were 9.06% (95% CI: 1.84, 15.00) and 15.09% (95% CI: 5.86, 21.96), respectively. Besides, elderly people were more vulnerable to cold temperature than the young.
Measures should be taken to increase public awareness about the ill effects of cold temperature on stroke attack, and educate the public about self-protection.
中风是中国主要的死亡原因和公共卫生负担。中国有关不同中风发作属性与环境温度关系的证据有限。本研究旨在根据广州（中国最发达的城市之一）的医院入院数据，展示中风发作的特征和因温度导致的可归因风险。
2013 年 1 月 1 日至 2015 年 12 月 31 日，对来自广州 67 家中风监测哨点医院的 104432 名广州居民的中风住院病例进行了登记。分析了按性别、年龄组、日历年度和中风亚型划分的入院特征，并应用分布滞后非线性模型评估温度对中风发作入院的影响。
2013 年至 2015 年，中风发作入院人数从 31851 例增加到 36755 例，增加了 15.4%。观察到无论中风亚型和日历年度如何，年龄与中风发作风险呈递增趋势。患有高血压的人比没有高血压的人更容易发生相关中风。低温对 CBI 和 ICH 中风发作的影响显著。总体而言，CBI 和 ICH 发作入院归因于低温的比例分别为 9.06%（95%可信区间：1.84，15.00）和 15.09%（95%可信区间：5.86，21.96）。此外，老年人比年轻人更容易受到低温的影响。
应采取措施提高公众对低温对中风发作不良影响的认识，并教育公众自我保护。
