Basurto University Hospital, Montevideo Avenue, 18, 48013, Bilbao, Basque Country, Spain.
Vicomtech Research Centre, Mikeletegi Street, 57, San Sebastian's technological park, 20009, San Sebastián, Basque Country, Spain.
ESC Heart Fail. 2019 Dec;6(6):1226-1232. doi: 10.1002/ehf2.12506. Epub 2019 Sep 4.
Heart failure (HF) is a clinical syndrome caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. This disease often causes decompensations, which may lead to hospital admissions, deteriorating patients' quality of life and causing an increment on the healthcare cost. Environmental exposure is an important but underappreciated risk factor contributing to the development and severity of cardiovascular diseases, such as HF.
We used two different sets of data (January 2012 to August 2017): one related to the number of hospital admissions and the other one related to the environmental factors (weather and air quality). Admissions related data were grouped in weeks, and then two different studies were performed: (i) a univariate regression to determine whether the admissions may influence future hospitalizations prediction and (ii) a multivariate regression to determine the impact of environmental factors on admission rates. A total number of 8338 hospitalizations of 5343 different patients are available in this dataset, with a mean of 4.02 admissions per day. In European warm period (from June to October), there are significant less admissions than that in the cold period (from December to March), with a clear seasonality of admissions, because there is a similar pattern every year. Air temperature is the most significant environmental factor (r = -0.3794, P < 0.001) related to HF hospital admissions, showing an inversed correlation. Some other attributes, such as precipitation (r = 0.0795, P = 0.05), along with SO (precursor of acid rain) (r = 0.2692, P < 0.001) and NOX air (major air pollutant formed by combustion systems and motor vehicles) (r = 0.2196, P < 0.001) quality parameters, are also relevant. Humidity and PM10 parameters do not have significant correlations in this study (r = 0.0469 and r = -0.0485 respectively), neither relevant P-values (P = 0.238 and P = 0.324, respectively).
Several environmental factors, such as weather temperature and precipitation, and major air pollutants, such as SO and NOX air, have an impact on the HF-related hospital admissions rate and, hence, on HF decompensations and patient's quality of life.
心力衰竭（HF）是一种由心脏结构和/或功能异常引起的临床综合征，导致静息或应激时心输出量降低和/或心内压升高。这种疾病经常导致失代偿，可能导致住院，降低患者的生活质量，并增加医疗保健成本。环境暴露是导致心血管疾病（如 HF）发展和严重程度的一个重要但未被充分认识的危险因素。
我们使用了两组不同的数据（2012 年 1 月至 2017 年 8 月）：一组与住院人数有关，另一组与环境因素（天气和空气质量）有关。住院相关数据按周分组，然后进行了两项不同的研究：（i）单变量回归以确定住院是否会影响未来的住院预测；（ii）多变量回归以确定环境因素对入院率的影响。该数据集共包含 5343 名不同患者的 8338 次住院，平均每天有 4.02 次住院。在欧洲温暖期（6 月至 10 月），入院人数明显少于寒冷期（12 月至 3 月），具有明显的季节性，因为每年都有类似的模式。气温是与 HF 住院相关的最重要的环境因素（r = -0.3794，P < 0.001），呈负相关。其他一些属性，如降水（r = 0.0795，P = 0.05），以及 SO（酸雨的前体）（r = 0.2692，P < 0.001）和 NOX 空气（由燃烧系统和机动车辆形成的主要空气污染物）（r = 0.2196，P < 0.001）质量参数也很相关。在这项研究中，湿度和 PM10 参数没有显著相关性（r = 0.0469 和 r = -0.0485），相应的 P 值也没有显著相关性（P = 0.238 和 P = 0.324）。
天气温度和降水等一些环境因素以及 SO 和 NOX 空气等主要空气污染物都会影响 HF 相关的住院率，从而影响 HF 失代偿和患者的生活质量。
