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中国西北地区心血管疾病入院和死亡与温度变化的相关性研究。

A study of temperature variability on admissions and deaths for cardiovascular diseases in Northwestern China.

机构信息

Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China.

Center for Immunological and Metabolic Diseases (CIMD), MED-X Institute, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

BMC Public Health. 2023 Sep 8;23(1):1751. doi: 10.1186/s12889-023-16650-3.

Abstract

OBJECTIVE

To explore the effect of temperature variability (TV) on admissions and deaths for cardiovascular diseases (CVDs).

METHOD

The admissions data of CVDs were collected in 4 general hospitals in Jinchang City, Gansu Province from 2013 to 2016. The monitoring data of death for CVDs from 2013 to 2017 were collected through the Jinchang City Center for Disease Control and Prevention. Distributed lag nonlinear model (DLNM) was combined to analyze the effects of TV (daily temperature variability (DTV) and hourly temperature variability (HTV)) on the admissions and deaths for CVDs after adjusting confounding effects. Stratified analysis was conducted by age and gender. Then the attribution risk of TV was evaluated.

RESULTS

There was a broadly linear correlation between TV and the admissions and deaths for CVDs, but only the association between TV and outpatient and emergency room (O&ER) visits for CVDs have statistically significant. DTV and HTV have similar lag effect. Every 1 ℃ increase in DTV and HTV was associated with a 3.61% (95% CI: 1.19% ~ 6.08%), 3.03% (95% CI: 0.27% ~ 5.86%) increase in O&ER visits for CVDs, respectively. There were 22.75% and 14.15% O&ER visits for CVDs can attribute to DTV and HTV exposure during 2013-2016. Males and the elderly may be more sensitive to the changes of TV. Greater effect of TV was observed in non-heating season than in heating season.

CONCLUSION

TV was an independent risk factor for the increase of O&ER visits for CVDs, suggesting effective guidance such as strengthening the timely prevention for vulnerable groups before or after exposure, which has important implications for risk management of CVDs.

摘要

目的

探讨温度变异性(TV)对心血管疾病(CVD)住院和死亡的影响。

方法

收集甘肃省金昌市 4 家综合医院 2013-2016 年 CVD 住院数据,通过金昌市疾病预防控制中心收集 2013-2017 年 CVD 死亡监测数据。采用分布滞后非线性模型(DLNM)调整混杂因素后分析 TV(日温度变异性(DTV)和小时温度变异性(HTV))对 CVD 住院和死亡的影响,并进行年龄和性别分层分析。然后评估 TV 的归因风险。

结果

TV 与 CVD 住院和死亡呈广泛线性相关,但仅与 CVD 门诊和急诊(O&ER)就诊呈统计学显著相关。DTV 和 HTV 具有相似的滞后效应。DTV 和 HTV 每增加 1℃,CVD 门诊和急诊就诊率分别增加 3.61%(95%CI:1.19%6.08%)和 3.03%(95%CI:0.27%5.86%)。2013-2016 年,DTV 和 HTV 可导致 22.75%和 14.15%的 CVD 门诊和急诊就诊,男性和老年人可能对 TV 的变化更敏感。在非供暖季,TV 的影响大于供暖季。

结论

TV 是 CVD 门诊和急诊就诊增加的独立危险因素,提示在暴露前后对脆弱人群进行及时预防等有效指导,对 CVD 风险管理具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84bc/10486070/447359f0c992/12889_2023_16650_Fig1_HTML.jpg

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