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中国北京极端温度对特定病因心血管疾病入院的短期影响。

Short-term effects of extreme temperatures on cause specific cardiovascular admissions in Beijing, China.

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.

Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Commission of Health and Family Planning Information Center, China.

出版信息

Environ Res. 2020 Jul;186:109455. doi: 10.1016/j.envres.2020.109455. Epub 2020 Apr 3.

Abstract

Extreme temperature-related cardiovascular diseases (CVDs) have become a growing public health concern. However, the impact of temperature on the cause of specific CVDs has not been well studied in the study area. The objective of this study was to assess the impact of temperature on cause-specific cardiovascular hospital admissions in Beijing, China. We obtained data from 172 large general hospitals from the Beijing Public Health Information Center Cardiovascular Case Database and China. Meteorological Administration covering 16 districts in Beijing from 2013 to 2017. We used a time-stratified case crossover design with a distributed lag nonlinear model (DLNM) to derive the impact of temperature on CVD in hospitals back to 27 days on CVD admissions. The temperature data were stratified as cold (extreme and moderate ) and hot (moderate and extreme ). Within five years (January 2013-December 2017), a total of 460,938 (male 54.9% and female 45.1%) CVD admission cases were reported. The exposure-response relationship for hospitalization was described by a "J" shape for the total and cause-specific. An increase in the six-day moving average temperature from moderate hot (30.2 °C) to extreme hot (36.9 °C) resulted in a significant increase in CVD admissions of 16.1%(95% CI = 12.8%-28.9%). However, the effect of cold temperature exposure on CVD admissions over a lag time of 0-27 days was found to be non significant, with a relative risk of 0.45 (95% CI = 0.378-0.55) for extreme cold (-8.5 °C)and 0.53 (95% CI = 0.47-0.60) for moderate cold (-5.6 °C). The results of this study indicate that exposure to extremely high temperatures is highly associated with an increase in cause-specific CVD admissions. These finding may guide to create and raise awareness of the general population, government and private sectors regarding on the effects of current weather conditions on CVD.

摘要

与极端温度相关的心血管疾病(CVDs)已成为日益严重的公共卫生问题。然而,在研究区域内,温度对特定 CVD 病因的影响尚未得到很好的研究。本研究旨在评估温度对中国北京特定病因心血管疾病住院的影响。我们从北京公共卫生信息中心心血管病例数据库和中国气象局获得了 2013 年至 2017 年北京 16 个区 172 家大型综合医院的数据。我们使用时间分层病例交叉设计和分布式滞后非线性模型(DLNM)来评估温度对 CVD 入院的影响,回溯至 27 天。温度数据分为冷(极冷和冷)和热(暖和极热)。在五年内(2013 年 1 月至 2017 年 12 月),共报告了 460938 例(男性占 54.9%,女性占 45.1%)CVD 入院病例。总病例和特定病因病例的住院暴露反应关系呈“J”形。与中温(30.2°C)相比,六天移动平均温度升高至极热(36.9°C),CVD 入院人数显著增加 16.1%(95%可信区间为 12.8%-28.9%)。然而,在 0-27 天的滞后时间内,冷暴露对 CVD 入院的影响并不显著,极冷(-8.5°C)的相对风险为 0.45(95%可信区间为 0.378-0.55),中冷(-5.6°C)的相对风险为 0.53(95%可信区间为 0.47-0.60)。本研究结果表明,暴露于极高温度与特定病因 CVD 入院人数的增加高度相关。这些发现可能为政府和私营部门制定和提高公众对当前天气条件对 CVD 影响的认识提供指导。

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