Department of Neurology, The Second Hospital of Tianjin Medical University.
Tianjin Environmental Meteorology Center.
Circ J. 2023 Aug 25;87(9):1187-1195. doi: 10.1253/circj.CJ-22-0801. Epub 2023 Apr 8.
Because the effects of extreme weather conditions on stroke severity and outcomes are unclear, we evaluated seasonal variations in stroke severity and clinical outcomes.
Between 2012 and 2020 we enrolled 5,238 patients with acute ischemic stroke, who were divided into 4 seasons according to stroke onset: spring, summer, autumn and winter. We analyzed the effect of season on the severity and outcomes of all subjects. Multivariable analysis showed that the winter group had 1.234-fold increased risk of moderate-to-severe neurological deficits than the summer group (95% confidence interval (CI): 1.034-1.472, P=0.020). Compared with the summer group, the winter and the spring groups experienced 1.243- and 1.251-fold the risk of suffering from worse outcomes among all patients at 6-month follow-up (95% CI 1.008-1.534, P=0.042, 95% CI 1.013-1.544, P=0.037). The 1-year follow-up revealed similar results. Further comparison of each season in the 2012-2015 and 2016-2020 periods found that the proportion of poor outcomes in the latter autumn group was lower than that in the former time period, with significant differences in both 6-month and 1-year follow-up.
The onset season was related to the severity and clinical outcomes of ischemic stroke. Patients with winter onset had more severe neurological deficits and worse outcomes than those with summer onset.
由于极端天气条件对卒中严重程度和结局的影响尚不清楚，我们评估了卒中严重程度和临床结局的季节性变化。
在 2012 年至 2020 年期间，我们纳入了 5238 例急性缺血性卒中患者，根据卒中发病时间将其分为 4 个季节：春季、夏季、秋季和冬季。我们分析了季节对所有患者严重程度和结局的影响。多变量分析显示，冬季组中度至重度神经功能缺损的风险比夏季组高 1.234 倍（95%置信区间：1.034-1.472，P=0.020）。与夏季组相比，冬季组和春季组所有患者在 6 个月随访时发生不良结局的风险分别增加了 1.243 倍和 1.251 倍（95%置信区间 1.008-1.534，P=0.042；95%置信区间 1.013-1.544，P=0.037）。1 年随访结果相似。进一步比较 2012-2015 年和 2016-2020 年期间每个季节的情况发现，后者秋季组不良结局的比例低于前者，6 个月和 1 年随访均有显著差异。
发病季节与缺血性卒中的严重程度和临床结局有关。冬季发病的患者神经功能缺损更严重，结局更差。
