Garg Rajeev Kumar, Ouyang Bichun, Pandya Vishal, Garcia-Cano Raquel, Da Silva Ivan, Hall Deborah, John Sayona, Bleck Thomas Pritchett, Berkelhammer Max
Rush University Medical Center, Department of Neurological Sciences, Chicago, Illinois.
Medical College of Wisconsin, Department of Neurology, Milwaukee, Wisconsin.
J Stroke Cerebrovasc Dis. 2019 Feb;28(2):405-411. doi: 10.1016/j.jstrokecerebrovasdis.2018.10.011. Epub 2018 Nov 8.
Intracerebral hemorrhage has been associated with changes in various weather conditions. The primary aim of this study was to examine the collective influence of temperature, barometric pressure, and dew point temperature on the incidence of primary spontaneous intracerebral hemorrhage (sICH).
Between January 2013 and December 2016, patients with sICH due to hypertension or amyloid angiopathy with a known time of onset were identified prospectively. Meteorological variables 6 hours prior to time of onset were obtained from the National Oceanic Atmospheric Administration via two weather stations. Using a Monte-Carlo simulation, random populations of meteorological conditions in a 6-hour time window during the same years were generated. The actual meteorological conditions 6-hours prior to sICH were compared to those from the randomly generated populations. The false discovery rate method was used to identify significant meteorological variables.
Time of onset was identified in 455 of 603 (75.5%) patients. Distribution curves for change in temperature, mean barometric pressure, and change in barometric pressure 6-hours prior to hemorrhage ictus were found to be significantly different from the random populations. (FDR approach P < .05). For a given change in temperature associated with intracerebral hemorrhage, mean barometric pressure was higher (1018 millibar (mb) versus 1016 mb, P = .03). Barometric pressure data was not influenced by variations in temperature.
We concluded that barometric pressure primarily influences the incidence of intracerebral hemorrhage. The association described in the literature between temperature and intracerebral hemorrhage is likely confounded by variations in barometric pressure.
脑出血与多种天气状况的变化有关。本研究的主要目的是探讨温度、气压和露点温度对原发性自发性脑出血（sICH）发病率的综合影响。
在2013年1月至2016年12月期间，前瞻性地识别出因高血压或淀粉样血管病导致的已知发病时间的sICH患者。发病前6小时的气象变量通过两个气象站从美国国家海洋和大气管理局获取。使用蒙特卡洛模拟，生成同一年中6小时时间窗口内气象条件的随机总体。将sICH发病前6小时的实际气象条件与随机生成总体的气象条件进行比较。采用错误发现率方法识别显著的气象变量。
在603例患者中的455例（75.5%）确定了发病时间。发现出血发作前6小时的温度变化、平均气压和气压变化的分布曲线与随机总体有显著差异（错误发现率方法P < .05）。对于与脑出血相关的给定温度变化，平均气压更高（1018毫巴（mb）对1016 mb，P = .03）。气压数据不受温度变化的影响。
我们得出结论，气压主要影响脑出血的发病率。文献中描述的温度与脑出血之间的关联可能受到气压变化的混淆。
