Penning de Vries Bas B L, Kolkert Joé L P, Meerwaldt Robbert, Groenwold Rolf H H
1 Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
2 Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
Vasc Endovascular Surg. 2017 Oct;51(7):441-446. doi: 10.1177/1538574417713909. Epub 2017 Jul 25.
Associations between atmospheric pressure and abdominal aortic aneurysm (AAA) rupture risk have been reported, but empirical evidence is inconclusive and largely derived from studies that did not account for possible nonlinearity, seasonality, and confounding by temperature.
Associations between atmospheric pressure and AAA rupture risk were investigated using local meteorological data and a case series of 358 patients admitted to hospital for ruptured AAA during the study period, January 2002 to December 2012. Two analyses were performed-a time series analysis and a case-crossover study.
Results from the 2 analyses were similar; neither the time series analysis nor the case-crossover study showed a significant association between atmospheric pressure ( P = .627 and P = .625, respectively, for mean daily atmospheric pressure) or atmospheric pressure variation ( P = .464 and P = .816, respectively, for 24-hour change in mean daily atmospheric pressure) and AAA rupture risk.
This study failed to support claims that atmospheric pressure causally affects AAA rupture risk. In interpreting our results, one should be aware that the range of atmospheric pressure observed in this study is not representative of the atmospheric pressure to which patients with AAA may be exposed, for example, during air travel or travel to high altitudes in the mountains. Making firm claims regarding these conditions in relation to AAA rupture risk is difficult at best. Furthermore, despite the fact that we used one of the largest case series to date to investigate the effect of atmospheric pressure on AAA rupture risk, it is possible that this study is simply too small to demonstrate a causal link.
已有报道称大气压力与腹主动脉瘤（AAA）破裂风险之间存在关联，但实证证据尚无定论，且大多来自未考虑可能的非线性、季节性以及温度混杂因素的研究。
利用当地气象数据以及2002年1月至2012年12月研究期间358例因AAA破裂入院患者的病例系列，调查大气压力与AAA破裂风险之间的关联。进行了两项分析——时间序列分析和病例交叉研究。
两项分析结果相似；时间序列分析和病例交叉研究均未显示大气压力（平均每日大气压力的P值分别为0.627和0.625）或大气压力变化（平均每日大气压力24小时变化的P值分别为0.464和0.816）与AAA破裂风险之间存在显著关联。
本研究未能支持大气压力因果性影响AAA破裂风险的说法。在解释我们的结果时，应意识到本研究中观察到的大气压力范围并不代表AAA患者可能暴露于其中的大气压力，例如在航空旅行或前往山区高海拔地区期间。就这些情况与AAA破裂风险的关系做出确凿论断充其量是困难的。此外，尽管我们使用了迄今为止最大的病例系列之一来研究大气压力对AAA破裂风险的影响，但本研究可能只是规模太小而无法证明因果联系。
