环境温度与卢布尔雅那地区缺血性卒中的时间序列分析：即时、延迟和累积效应。
A time series analysis of the relationship between ambient temperature and ischaemic stroke in the Ljubljana area: immediate, delayed and cumulative effects.
机构信息
University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, Ljubljana, Slovenia.
University Medical Centre Ljubljana, Neurology Clinic, Department of Vascular Neurology and Neurological Intensive Care, Zaloška cesta 2, Ljubljana, Slovenia.
出版信息
BMC Neurol. 2021 Jan 14;21(1):23. doi: 10.1186/s12883-021-02044-8.
BACKGROUND
Stroke is a major health problem around the world. Several studies have examine the influence of ambient temperature on incidence of stoke, but they reported different results for different types of stroke and different geographical regions. Hence, effect of ambient temperature is still much of interest, when focusing on ischemic stroke (IS) in regions that have not been examined yet. The aim of our study is to analyse association between IS incidences and short, delayed and cumulative effect of average daily ambient temperature, humidity and pressure in central Europe. To the best of our knowledge, this is the first IS study conducted between 45° and 50° latitude where large part of Central European population resides.
METHODS
We linked daily hospitals' admission data for whole population and separately for two specific age groups with ambient temperature data. We considered patients coming from Ljubljana basin and its immediate surrounding. Data were gathered daily from January 2012 to December 2017. To measure the effect of average ambient temperature, humidity and pressure we used generalized linear model with a log-link-function and a Poisson distribution.
RESULTS
The results of our study show a statistically significant immediate, delayed and cumulative effects of ambient temperatures on IS incidence for the whole population and the population older than 65 years. Specifically, 1 °C reduction in ambient temperature on a given day (Lag 0) increases the IS risk for approximately 5‰ (all population) or 6‰ (population older than 65 years). Similar effects were found for lags from 1 to 6. Analysis of time windows from 0 to 1 days up to 0-28 days also show statistically significant cumulative effect for the same two age groups. IS incidence was not found to be significantly related to pressure or humidity in any group.
CONCLUSION
The findings of this study may help healthcare authorities in central Europe improve existing stroke prevention measures and raise public awareness.
背景
中风是全球范围内的一个主要健康问题。有几项研究探讨了环境温度对中风发病率的影响，但针对不同类型的中风和不同地理区域，它们的报告结果有所不同。因此，当关注尚未研究过的中纬度地区的缺血性中风（IS）时，环境温度的影响仍然是一个重要关注点。我们的研究旨在分析中欧地区 IS 发病率与短期、延迟和平均日环境温度、湿度和气压累积效应之间的关联。据我们所知，这是在 45°至 50°纬度之间进行的首次 IS 研究，该地区居住着中欧地区的大部分人口。
方法
我们将全人群和两个特定年龄组的每日医院入院数据与环境温度数据相关联。我们考虑了来自卢布尔雅那盆地及其周边地区的患者。数据从 2012 年 1 月到 2017 年 12 月每日收集。为了测量环境平均温度、湿度和气压的影响，我们使用了广义线性模型，具有对数链接函数和泊松分布。
结果
我们的研究结果表明，环境温度对全人群和 65 岁以上人群的 IS 发病率具有统计学上显著的即时、延迟和累积影响。具体而言，在给定的一天（滞后 0）中环境温度降低 1°C，IS 风险增加约 5‰（全人群）或 6‰（65 岁以上人群）。类似的影响也在 1 到 6 天的滞后期内发现。对 0 到 1 天到 0 到 28 天的时间窗口的分析也显示了相同的两个年龄组的累积效应具有统计学意义。在任何一组中，都未发现 IS 发病率与压力或湿度有显著关系。
结论
本研究的结果可能有助于中欧地区的医疗保健当局改进现有的中风预防措施并提高公众意识。
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