Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany,
Institute of Geography, University of Augsburg, Augsburg, Germany.
Cerebrovasc Dis. 2019;47(5-6):275-284. doi: 10.1159/000501843. Epub 2019 Jul 25.
BACKGROUND/OBJECTIVES: Meteorological factors seem to influence stroke incidence, however, the complex association between weather and stroke remains unclear. Possible explanations from the literature do not categorize into subdivisions of ischemic strokes, only have small patient numbers, or refer to a selection of isolated weather elements without investigating weather changes and more.
In this exploratory trial, almost 18,000 stroke cases from a single stroke center in Southern Germany were analyzed from 2006 to 2015 and classified into the main subgroups of strokes and subdivisions of ischemic stroke etiologies applying the Trial of Org 10172 in Acute Stroke Treatment classification. For each stroke event, the air mass classification was determined from a subset of 7 air mass categories. Relative excess morbidities were derived for the 7 different air mass categories, taking into account the day of the event and up to 2 and 5 days preceding the stroke event.
Statistically significant findings (α ≤0.1) reveal that dry tropical air masses were associated with a lower/higher risk for hemorrhagic (HEM)/macroangiopathic strokes (MAS), respectively. Dry polar air masses were associated with a higher risk for intracerebral bleedings and lower risk for ischemic stroke subtypes. Moist air masses were associated with a reduced incidence of MAS. A strong temperature increase 5 days prior to the event was associated with a lower risk of HEM strokes. Temperature increases were associated with lower risks for MAS and cardio-embolic strokes. Significant temperature decreases were associated with a higher risk of MAS.
Temperature effects were dependent on both air masses and temperature changes within 5 days prior to the event and were associated with statistically relevant changes in stroke incidence. Decisive factors such as etiology, age, sex, and risk factors were also taken into account.
背景/目的：气象因素似乎会影响中风的发病率，但天气与中风之间的复杂关系仍不清楚。文献中的可能解释没有对缺血性中风进行细分，患者数量较少，或者仅提到选择孤立的天气因素，而没有调查天气变化等情况。
在这项探索性试验中，从德国南部的一个单一卒中中心分析了 2006 年至 2015 年期间近 18000 例卒中病例，并根据急性卒中治疗试验分类（Trial of Org 10172 in Acute Stroke Treatment classification）将其分为主要的卒中亚组和缺血性卒中病因的细分。对于每个卒中事件，从 7 个气团类别子集确定气团分类。考虑到事件当天以及卒中事件前 2 天和 5 天，得出 7 种不同气团类别的相对超额发病率。
有统计学意义的发现（α≤0.1）表明，干燥热带气团与出血性（HEM）/大血管性中风（MAS）的风险降低/升高分别相关。干燥极地气团与颅内出血风险升高和缺血性中风亚型风险降低相关。潮湿气团与 MAS 发病率降低相关。事件前 5 天温度大幅升高与 HEM 中风风险降低相关。温度升高与 MAS 和心源性中风的风险降低相关。显著的温度下降与 MAS 风险升高相关。
温度效应取决于气团和事件前 5 天内的温度变化，并与中风发病率的统计学相关变化相关。还考虑了决定性因素，如病因、年龄、性别和危险因素。
