Department of General Surgery, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Shenyang, 110000, China.
Liaoning Provincial Meteorological Training Center, Liaoning Branch of China Meteorological Administration Training Center (CMATC), Shenyang, China.
Int J Biometeorol. 2018 Sep;62(9):1733-1743. doi: 10.1007/s00484-018-1573-8. Epub 2018 Jun 25.
Ruptured abdominal aortic aneurysm (rAAA) is a life-threatening condition with a high mortality rate. Seasonal variations in the incidence of rAAA and the influence of atmospheric pressure have been studied throughout decades; however, the conclusions are contradictory. Therefore, we aimed to conduct a meta-analysis and systematic review of literature on seasonal variations in rAAA incidence and the influence of atmospheric pressure. Studies investigating seasonal variations in rAAA incidence and influence of atmospheric pressure were retrieved. For dichotomous data, we generated risk ratios (RRs) and 95% confidence intervals (CIs) for rAAA incidence compared among seasons. The studies were subdivided according to latitude, elevation, and climatic types, for subgroup comparisons. Studies reporting monthly incidence and seasonal mortality were further investigated. For continuous data, standardized mean differences (SMDs) and 95% CIs were generated for atmospheric pressure comparisons. Twenty-four eligible studies were included, comprising a total of 38,506 patients with rAAA. Pooled rAAA incidence was 25% in spring, 23% in summer, 26% in autumn, and 26% in winter. Pooled analysis demonstrated a statistically significant higher rAAA incidence in winter than in summer (RR 1.10, P = 0.04) and in autumn than in summer (RR 1.11, P < 0.00001). However, there was no statistically significant difference among other seasons. In the study of the influence of atmospheric pressure, no statistically significant difference was observed. In conclusion, our study revealed a higher incidence of rAAA in autumn and winter than in summer; however, atmospheric pressure was found to exert no influence.
破裂性腹主动脉瘤（rAAA）是一种危及生命的疾病，死亡率很高。数十年来，人们一直在研究 rAAA 的发病率的季节性变化和大气压的影响，但结论却相互矛盾。因此，我们旨在对 rAAA 发病率的季节性变化和大气压影响的文献进行荟萃分析和系统评价。检索了研究 rAAA 发病率的季节性变化和大气压影响的研究。对于二项数据，我们生成了季节间 rAAA 发病率比较的风险比（RR）和 95%置信区间（CI）。根据纬度、海拔和气候类型对研究进行了细分，以便进行亚组比较。进一步调查了报告每月发病率和季节性死亡率的研究。对于连续数据，生成了大气压比较的标准化均数差（SMD）和 95%CI。共有 24 项符合条件的研究纳入分析，共纳入 38506 例 rAAA 患者。春季 rAAA 的总发病率为 25%，夏季为 23%，秋季为 26%，冬季为 26%。汇总分析表明，冬季 rAAA 的发病率明显高于夏季（RR 1.10，P=0.04），秋季也明显高于夏季（RR 1.11，P<0.00001）。然而，其他季节之间没有统计学上的显著差异。在大气压影响的研究中，没有观察到统计学上的显著差异。总之，我们的研究表明 rAAA 在秋季和冬季的发病率高于夏季；然而，大气压的影响并不显著。
