Department of Clinical and Experimental Medicine. University of Catania, Italy; Internal Medicine Unit. University Hospital "G. Rodolico", Catania, Italy.
Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia". University of Catania, Italy.
Environ Res. 2021 Jun;197:110950. doi: 10.1016/j.envres.2021.110950. Epub 2021 Mar 16.
Several cardiovascular conditions exhibit seasonality in frequency and mortality, but little is known about the seasonality of Venous ThromboEmbolism (VTE), a very relevant medical condition, and seasonal influences are still conflicting. Patients having co-morbidities, individual suffered from dyspnea, swelling, edema of lower limb, pain (chest, lower limbs) are admitted frequently to the hospital emergency room (HER), particularly. Both mark a potential risk for VTE, that can be increased also by seasonality. A four years retrospective analysis (2016-2019) was carried out in individuals and patients admitted to the HER of the Hospital of Catania (a Mediterranean city of Sicily, Italy) to evaluate the VTE frequency and its seasonal differences, common symptoms, potential usage of some common laboratory tests. Dyspnea, swelling, edema of lower limb and pain (chest, lower limbs) were considered to suspect pulmonary embolism (PE) or for deep vein thrombosis of lower limb (DVT). Platelet count, platelet volume, fibrinogen, C-reactive protein, and D-dimer were considered. VTE frequency per year was 2.9/10,000 (2016), 4.9/10,000 (2017) 3.6/10,000 (2018), and 5.1/10,000 (2019) respectively. Dyspnea was highly frequent for PE, edema and lower limb pain were frequent in DVT patients. Fibrinogen, C reactive protein, and D-dimer values were found raised in all the VTE patients. Platelet volume was found higher in DVT than PE VTE events that occurred in warm periods were modestly greater (57 VTE: 38 DVT, 19 PE) compared to cold months (52 VTE: 34 DVT, 18 PE). Our results could be explained by the increased sweating due to the high temperatures, which in turn, can affect both on plasma concentration and on hematocrit value coupled to the reduction in atmospheric pressure determining both a hyper-coagulative condition. Climate seasonal characteristics, and environmental conditions in Catania city (Sicily) may be as reasonable items in expecting on different VTE rates in warm period compared to cold. This study highlights no specific symptoms, and confirms the common lab tests for individuals and patients admitted to HER as simple and helpful tools in initiating none or mini-invasive diagnostic strategy for the VTE. Finally, the climate/seasonality coupled with latitude can have a direct influence on the incidence of DVT.
一些心血管疾病在频率和死亡率上表现出季节性，但关于静脉血栓栓塞症（VTE）的季节性知之甚少，静脉血栓栓塞症是一种非常相关的医学病症，而且季节影响仍然存在争议。患有合并症的患者、呼吸困难、下肢肿胀、下肢水肿、疼痛（胸部、下肢）的患者经常被收入医院急诊室（HER），特别是在高温时期。这些都标志着 VTE 的潜在风险增加，而季节因素也会增加这种风险。对 2016 年至 2019 年期间在西西里岛卡塔尼亚医院 HER 住院的个人和患者进行了四年回顾性分析，以评估 VTE 的频率及其季节性差异、常见症状、一些常见实验室检测的潜在用途。呼吸困难、下肢肿胀、水肿和疼痛（胸部、下肢）被认为是肺栓塞（PE）或下肢深静脉血栓形成（DVT）的可疑症状。血小板计数、血小板体积、纤维蛋白原、C 反应蛋白和 D-二聚体被认为是 DVT 的潜在用途。每年 VTE 的发生率分别为 2.9/10000（2016 年）、4.9/10000（2017 年）、3.6/10000（2018 年）和 5.1/10000（2019 年）。呼吸困难是 PE 的高频率症状，下肢水肿和疼痛是 DVT 患者的常见症状。所有 VTE 患者的纤维蛋白原、C 反应蛋白和 D-二聚体值均升高。与发生在寒冷月份的 VTE 相比，发生在温暖时期的 DVT 事件的血小板体积略高（57 例 VTE：38 例 DVT，19 例 PE）。我们的结果可以用高温引起的出汗增加来解释，这反过来又会影响血浆浓度和与大气压降低相关的血细胞比容值，导致高凝状态。卡塔尼亚市（西西里岛）的气候季节性特征和环境条件可能是导致温暖期 VTE 发生率与寒冷期不同的合理因素。本研究没有发现特定症状，并证实了 HER 住院患者和个体的常规实验室检查是启动无创伤或微创诊断策略的简单而有帮助的工具。最后，气候/季节性加上纬度会对 DVT 的发病率产生直接影响。
