与糖尿病、吸烟和老年相关的心脏手术比例的季节性变化。

Seasonal changes in proportion of cardiac surgeries associated with diabetes, smoking and elderly age.

机构信息

Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.

Department of Anesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary.

出版信息

PLoS One. 2022 Sep 22;17(9):e0274105. doi: 10.1371/journal.pone.0274105. eCollection 2022.

DOI:10.1371/journal.pone.0274105

PMID:36136994

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9498963/

Abstract

BACKGROUND

Seasonal variations in the ambient temperature may affect the exacerbation of cardiovascular diseases. Our primary objective was to evaluate the seasonality of the monthly proportion of cardiac surgeries associated with diabetes, smoking and/or elderly age at a tertiary-care university hospital in East-Central Europe with a temperate climate zone. As a secondary objective, we also assessed whether additional factors affecting small blood vessels (smoking, aging, obesity) modulate the seasonal variability of diabetes.

METHODS

Medical records were analyzed for 9838 consecutive adult patients who underwent cardiac surgery in 2007-2018. Individual seasonal variations of diabetes, smoking, and elderly patients were analyzed monthly, along with the potential risk factors for cardiovascular complication. We also characterized whether pairwise coexistence of diabetes, smoking, and elderly age augments or blunts the seasonal variations.

RESULTS

Seasonal variations in the monthly proportion of cardiac surgeries associated with diabetes, smoking and/or elderly age were observed. The proportion of cardiac surgeries of non-elderly and smoking patients with diabetes peaked in winter (amplitude of change as [peak-nadir]/nadir: 19.2%, p<0.02), which was associated with increases in systolic (6.1%, p<0.001) and diastolic blood pressures (4.4%, p<0.05) and serum triglyceride levels (27.1%, p<0.005). However, heart surgery in elderly patients without diabetes and smoking was most frequently required in summer (52.1%, p<0.001). Concomitant occurrence of diabetes and smoking had an additive effect on the requirement for cardiac surgery (107%, p<0.001), while the simultaneous presence of older age and diabetes or smoking eliminated seasonal variations.

CONCLUSIONS

Scheduling regular cardiovascular control in accordance with periodicities in diabetes, elderly, and smoking patients more than once a year may improve patient health and social consequences.

TRIAL REGISTRATION

NCT03967639.

摘要

背景

环境温度的季节性变化可能会影响心血管疾病的恶化。我们的主要目标是评估中欧温带气候区一家三级保健大学医院中与糖尿病、吸烟和/或老年相关的心脏手术的每月比例的季节性。作为次要目标，我们还评估了影响小血管的其他因素（吸烟、衰老、肥胖）是否调节糖尿病的季节性变化。

方法

对 2007 年至 2018 年期间接受心脏手术的 9838 例连续成年患者的病历进行了分析。每月分析糖尿病、吸烟和老年患者的个体季节性变化，以及心血管并发症的潜在危险因素。我们还描述了糖尿病、吸烟和老年患者同时存在是否会增加或减弱季节性变化。

结果

观察到与糖尿病、吸烟和/或老年相关的心脏手术的每月比例存在季节性变化。非老年和患有糖尿病且吸烟的患者的心脏手术比例在冬季达到峰值（变化幅度为[峰值-谷值]/谷值：19.2%，p<0.02），这与收缩压（6.1%，p<0.001）和舒张压（4.4%，p<0.05）以及血清甘油三酯水平（27.1%，p<0.005）的升高有关。然而，无糖尿病和吸烟的老年患者的心脏手术最常需要在夏季进行（52.1%，p<0.001）。同时患有糖尿病和吸烟的患者对心脏手术的需求有叠加效应（107%，p<0.001），而同时存在老年和糖尿病或吸烟则消除了季节性变化。