Wu Qiyue, Yang Min, Wu Keyu, Su Hong, Huang Cunrui, Xu Zhiwei, Ho Hung Chak, Zheng Hao, Zhang Wenyi, Tao Junwen, Dang Thi Anh Thu, Hossain Mohammad Zahid, Khan Md Alfazal, Bogale Daniel, Cheng Jian
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
Vanke School of Public Health, Tsinghua University, Beijing, China.
Sci Total Environ. 2023 Feb 25;861:160554. doi: 10.1016/j.scitotenv.2022.160554. Epub 2022 Nov 28.
There is growing evidence in support of a short-term association between ambient temperature and cardiac arrest attacks that is a serious manifestation of cardiovascular disease and has a high incidence and low survival rate. However, it remains unrecognized about the hazardous temperature exposure types, exposure risk magnitude, and vulnerable populations.
We comprehensively summarize prior epidemiological studies looking at the short-term associations of out-of-hospital cardiac arrest (OHCA) with various temperature exposures among different populations.
We searched PubMed and Web of Science databases from inception to October 2021 for eligible English language. Temperature exposure was categorized into three types: heat (included high temperature, extreme heat, and heatwave), cold (included low temperature and extreme cold), and temperature variation (included diurnal temperature range and temperature change between two adjacent days). Meta-analysis weighted by inverse variance was used to pool effect estimates.
This study included 15 studies from 8 countries, totaling around 1 million OHCA events. Extreme heat and extreme cold were significantly associated with an increased risk of OHCA, and the pooled relative risks (RRs) were 1.071 [95 % confidence interval (CI): 1.019-1.126] and 1.662 (95%CI: 1.138-2.427), respectively. The risk of OHCA was also elevated by heatwaves (RR = 1.248, 95%CI: 1.091-1.427) and more intensive heatwaves had a greater effect. Notably, the elderly and males seemed to be more vulnerable to the effects of heat and cold. However, we did not observe a significant association between temperature variation and the risk of OHCA (1.005, 95%CI: 0.999-1.012).
Short-term exposure to heat and cold may be novel risk factors for OHCA. Considering available studies in limited regions, the temperature effect on OHCA should be urgently confirmed in different regions.
越来越多的证据支持环境温度与心脏骤停发作之间存在短期关联，心脏骤停是心血管疾病的一种严重表现，发病率高且生存率低。然而，有害温度暴露类型、暴露风险程度和脆弱人群仍未得到认识。
我们全面总结了先前的流行病学研究，这些研究关注院外心脏骤停（OHCA）与不同人群中各种温度暴露的短期关联。
我们检索了PubMed和Web of Science数据库，从数据库创建到2021年10月，检索符合条件的英文文献。温度暴露分为三种类型：热（包括高温、酷热和热浪）、冷（包括低温和严寒）以及温度变化（包括日温度范围和相邻两天之间的温度变化）。采用逆方差加权的荟萃分析来汇总效应估计值。
本研究纳入了来自8个国家的15项研究，总计约100万例OHCA事件。酷热和严寒与OHCA风险增加显著相关，汇总相对风险（RRs）分别为1.071 [95%置信区间（CI）：1.019 - 1.126]和1.662（95%CI：1.138 - 2.427）。热浪也会增加OHCA风险（RR = 1.248，95%CI：1.091 - 1.427），更强的热浪影响更大。值得注意的是，老年人和男性似乎更容易受到热和冷的影响。然而，我们未观察到温度变化与OHCA风险之间存在显著关联（1.005，95%CI：0.999 - 1.012）。
短期暴露于热和冷可能是OHCA的新风险因素。考虑到有限区域的现有研究，不同地区应迫切确认温度对OHCA的影响。
