Rotim Ante, Raguž Marina, Gajski Domagoj, Vrban Filip, Jurilj Mia, Orešković Darko, Hrabar Josip, Kalousek Vladimir, Sajko Tomislav, Rotim Krešimir
Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Velika Gorica University of Applied Sciences, Velika Gorica, Croatia.
Acta Clin Croat. 2022 Dec;61(4):673-680. doi: 10.20471/acc.2022.61.04.14.
Spontaneous subarachnoid hemorrhage (SAH) can occur unexpectedly and independently of the classic risk factors. Several different factors could affect intracranial aneurysm (IA) rupture, such as morphological and hemodynamic factors. The aim of this study was to establish the potential association of meteorological data such as temperature, atmospheric pressure, and humidity, and the onset of clinical symptoms preceding hospital admission of patients with acute SAH due to IA rupture. This retrospective study included 130 consecutive patients admitted for non-traumatic SAH with a determinable onset of SAH symptoms. The effects of meteorological parameters of atmospheric pressure, ambient temperature, and relative air humidity on the day of acute SAH onset and 24 hours prior to the onset of symptoms were recorded and analyzed in each patient. Spearman rank correlation analysis was used to assess the risks of incident SAH on the basis of daily meteorological data. Seasonal incidence of acute SAH showed the peak incidence in winter and a trough in summer, with monthly incidence peak in January and December. The circadian rhythm analysis showed the peak incidence of SAH in the forenoon, followed by the evening. Acute SAH incidence showed moderate positive association with daily atmospheric pressure (p<0.05), while no association was found with ambient temperature and relative air humidity. Our results suggested no significant association of changes in ambient temperature and relative humidity with the risk of SAH. Increases in atmospheric pressure were weakly associated with a higher SAH risk. Additional studies are needed to establish in detail both meteorological and morphological factors important to predict IA rupture and SAH.
自发性蛛网膜下腔出血(SAH)可能意外发生,且与经典危险因素无关。几种不同因素可影响颅内动脉瘤(IA)破裂,如形态学和血流动力学因素。本研究的目的是确定气象数据(如温度、气压和湿度)与因IA破裂导致急性SAH患者入院前临床症状发作之间的潜在关联。这项回顾性研究纳入了130例连续因非创伤性SAH入院且SAH症状发作可确定的患者。记录并分析了每位患者急性SAH发作当天及症状发作前24小时的气压、环境温度和相对空气湿度等气象参数的影响。采用Spearman等级相关分析根据每日气象数据评估SAH发生风险。急性SAH的季节性发病率显示冬季发病率最高,夏季最低,1月和12月发病率月峰值。昼夜节律分析显示SAH发病率在上午最高,其次是晚上。急性SAH发病率与每日气压呈中度正相关(p<0.05),而与环境温度和相对空气湿度无关联。我们的结果表明环境温度和相对湿度的变化与SAH风险无显著关联。气压升高与较高的SAH风险弱相关。需要进一步研究以详细确定对预测IA破裂和SAH重要的气象和形态学因素。