van Donkelaar Carlina E, Potgieser Adriaan R E, Groen Henk, Foumani Mahrouz, Abdulrahman Herrer, Sluijter Rob, van Dijk J Marc C, Groen Rob J M
Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
World Neurosurg. 2018 Apr;112:e783-e790. doi: 10.1016/j.wneu.2018.01.155. Epub 2018 Feb 2.
There is an ongoing search for conditions that induce spontaneous subarachnoid hemorrhage (SAH). The seasonal pattern of SAH is shown in a large meta-analysis of the literature, but its explanation remains undecided. There is a clear need for sound meteorologic data to further elucidate the seasonal influence on SAH. Because of the stable and densely monitored atmospheric situation in the north of the Netherlands, we reviewed our unique cohort on the seasonal incidence of SAH and the association between SAH and local atmospheric changes.
Our observational cohort study included 1535 patients with spontaneous SAH admitted to our neurovascular center in the north of the Netherlands between 2000 and 2015. Meteorologic data could be linked to the day of the ictus. To compare SAH incidences over the year and to test the association with meteorologic conditions, incidence rate ratios (IRRs) with corresponding 95% confidence intervals (CIs) were used, calculated by Poisson regression analyses.
Atmospheric pressure variations were significantly associated with aneurysmal SAH. In particular, the pressure change on the second and third day before the ictus was independently correlated to a higher incidence of aneurysmal SAH (IRR, 1.11; 95% CI, 1.00-1.23). The IRR for aneurysmal SAH in July was calculated 0.67 (95% CI, 0.49-0.92) after adjustment for temperature and atmospheric pressure changes.
Atmospheric pressure variations are a delayed trigger for aneurysmal SAH. Also, a significantly decreased incidence of aneurysmal SAH was noted in July.
人们一直在寻找引发自发性蛛网膜下腔出血（SAH）的条件。SAH的季节性模式在一项大型文献荟萃分析中有所显示，但其解释仍未确定。显然需要可靠的气象数据来进一步阐明季节对SAH的影响。由于荷兰北部大气状况稳定且监测密集，我们回顾了我们关于SAH季节性发病率以及SAH与当地大气变化之间关联的独特队列研究。
我们的观察性队列研究纳入了2000年至2015年间在荷兰北部我们的神经血管中心收治的1535例自发性SAH患者。气象数据可与发病当日相关联。为比较一年中SAH的发病率并检验其与气象条件的关联，我们使用了通过泊松回归分析计算的发病率比（IRR）及其相应的95%置信区间（CI）。
大气压力变化与动脉瘤性SAH显著相关。特别是，发病前第二和第三天的压力变化与动脉瘤性SAH的较高发病率独立相关（IRR，1.11；95%CI，1.00 - 1.23）。在对温度和大气压力变化进行调整后，7月动脉瘤性SAH的IRR计算为0.67（95%CI，0.49 - 0.92）。
大气压力变化是动脉瘤性SAH的延迟触发因素。此外，7月动脉瘤性SAH的发病率显著下降。
