Kato Katsuhito, Nishino Takuya, Otsuka Toshiaki, Seino Yoshihiko, Kawada Tomoyuki
Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan.
Department of Health Care Administration, Nippon Medical School, Tokyo, Japan.
Eur J Prev Cardiol. 2025 Mar 18;32(4):317-324. doi: 10.1093/eurjpc/zwae278.
Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency. Therefore, identifying modifiable risk factors for AAD is of great public health significance. An association between ambient temperature (AT) and AAD has been reported; however, not all findings have been elucidated. This study examined the association between AAD-related hospitalization and AT using data from the Japanese Registry of All Cardiac and Vascular Diseases Diagnostic Procedure Combination (JROAD-DPC), which is a nationwide claims-based database.
This nationwide time-stratified case-crossover study evaluated data of hospitalized patients with AAD from 1119 certified hospitals between 2012 and 2020 using the JROAD-DPC database. Conditional logistic regression and distributed lag non-linear models were used to investigate the association between average daily temperature and AAD-related hospitalization. Among the 96 812 cases analysed, the exposure-response curve between AT and AAD-related hospitalization showed an increase in the odds ratio for lower temperatures, with a peak at time -10°C (odds ratio: 2.28, 95% confidence interval: 1.92-2.71, compared with that at 20°C). The effects of temperature on lag days 0 and 1 were also significant.Stratified analyses showed a greater association between AT and AAD-related hospitalization for the following variables: older age (≥75 years), female sex (44.4%, the mean age ± SD was 76 ± 12 years), low body mass index (<22), winter season, and warmer regions.
Low AT is associated with an increased risk of AAD-related hospitalization. Several susceptible groups are affected by cold temperatures and have a higher risk of hospitalization.
急性主动脉夹层（AAD）是一种危及生命的心血管急症。因此，识别AAD的可改变风险因素具有重大的公共卫生意义。已有报道称环境温度（AT）与AAD之间存在关联；然而，并非所有研究结果都已得到阐明。本研究利用日本全心血管疾病诊断程序组合登记系统（JROAD - DPC）的数据，该数据库是一个基于全国索赔的数据库，研究了AAD相关住院与AT之间的关联。
这项全国性的时间分层病例交叉研究使用JROAD - DPC数据库评估了2012年至2020年间1119家认证医院中AAD住院患者的数据。采用条件逻辑回归和分布滞后非线性模型来研究平均每日温度与AAD相关住院之间的关联。在分析的96812例病例中，AT与AAD相关住院之间的暴露 - 反应曲线显示，温度较低时比值比升高，在-10°C时达到峰值（比值比：2.28，95%置信区间：1.92 - 2.71，与20°C时相比）。温度对滞后0天和1天的影响也很显著。分层分析显示，对于以下变量，AT与AAD相关住院之间的关联更强：老年（≥75岁）、女性（44.4%，平均年龄±标准差为76±12岁）、低体重指数（<22）、冬季和较温暖地区。
低AT与AAD相关住院风险增加有关。几个易感人群受寒冷温度影响，住院风险更高。
