Keller Karsten, Hobohm Lukas, Münzel Thomas, Konstantinides Stavros V, Lankeit Mareike
Center for Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.
Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.
ERJ Open Res. 2020 Jun 22;6(2). doi: 10.1183/23120541.00181-2020. eCollection 2020 Apr.
Studies have reported seasonal variations regarding the incidence and the short-term mortality of pulmonary embolism (PE). The aim of this study was to identify sex-specific and age-related differences in seasonal patterns regarding hospitalisations and mortality of PE patients.
We analysed the impact of seasons on incidence and in-hospital mortality of male and female hospitalised PE patients in Germany (2005-2015) based on the German nationwide inpatient sample.
The German nationwide inpatient sample comprised 885 806 hospitalisations due to PE (2005-2015). Seasonal variations of both incidence (p=0.021) and in-hospital mortality (p<0.001) were of significant magnitude. Quarterly annual incidence (25.5 23.7 of 100 000 citizens per year, p=0.021) and in-hospital mortality (17.0% 16.7%, p=0.008) were higher in winter than in summer. Risk of in-hospital mortality in winter was slightly higher (OR 1.03 (95% CI 1.01-1.06), p=0.015) compared to summer, independently of sex, age and comorbidities. Additionally, we observed sex-specific differences during seasons: the highest number of hospitalisations of PE patients of both sexes was during winter, whereas the nadir of male patients was in spring and that of female patients was in summer. Both sexes showed a maximum of in-hospital mortality in spring. Seasonal variation regarding incidence and mortality was pronounced in older patients.
Incidence and the in-hospital mortality of PE patients showed a significant seasonal variation with sex-specific differences. Although it has to be hypothesised that the seasonal variation of PE is multifactorially dependent, variation in each season was not explained by seasonal differences regarding age, sex and the prevalence of important comorbidities.
研究报告了肺栓塞（PE）的发病率和短期死亡率存在季节性变化。本研究的目的是确定PE患者住院和死亡的季节性模式中性别特异性和年龄相关的差异。
我们基于德国全国住院患者样本，分析了季节对德国住院的男性和女性PE患者发病率和院内死亡率的影响（2005 - 2015年）。
德国全国住院患者样本包括885806例因PE住院的病例（2005 - 2015年）。发病率（p = 0.021）和院内死亡率（p < 0.001）的季节性变化幅度均显著。冬季的季度年发病率（每年每10万公民中有25.5例，p = 0.021）和院内死亡率（17.0%，p = 0.008）高于夏季。与夏季相比，冬季院内死亡风险略高（比值比1.03（95%置信区间1.01 - 1.06），p = 0.015），与性别、年龄和合并症无关。此外，我们观察到不同季节存在性别差异：男女PE患者住院人数最多的是冬季，而男性患者住院人数最低点在春季，女性患者在夏季。男女在春季的院内死亡率均最高。老年患者发病率和死亡率的季节性变化更为明显。
PE患者的发病率和院内死亡率存在显著的季节性变化且有性别差异。尽管必须假设PE的季节性变化是多因素依赖的，但每个季节的变化并不能用年龄、性别和重要合并症患病率的季节性差异来解释。
