热脆弱指数与脑卒中严重程度的相关性研究。
Association between Heat Vulnerability Index and Stroke Severity.
机构信息
Northwell Health, New Hyde Park, NY 11040, USA.
Institute of Health System Science, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA.
出版信息
Int J Environ Res Public Health. 2024 Aug 20;21(8):1099. doi: 10.3390/ijerph21081099.
BACKGROUND
Socioeconomically disadvantaged neighborhoods are particularly vulnerable to heat-related illnesses. We aim to investigate the association between the heat vulnerability index (HVI), an established neighborhood-level metric of heat-related mortality risk, and acute ischemic stroke (AIS) severity.
METHODS
We conducted a retrospective analysis of consecutive AIS admissions to a comprehensive stroke center between 2012 and 2021. Stroke severity was defined upon admission based on the National Institutes of Health Stroke Scale (NIHSS). Demographic, socioeconomic, and clinical characteristics were extracted from electronic health records. HVI status was assigned using residential ZIP codes. Multivariable logistic regression analyses were performed.
RESULTS
Of 3429 AIS admissions, 1123 (32.8%) were from high-HVI (scores 4-5) neighborhoods and 868 (25.3%) had severe stroke (NIHSS score ≥ 10). In the multivariable regression model with stepwise selection, a high HVI was independently associated with severe stroke (adjusted odds ratio: 1.40 [95% confidence interval 1.16-1.69]).
CONCLUSIONS
The association between a high HVI and severe stroke underscores the importance of targeting policy interventions to mitigate heat-related illness in socioeconomically disadvantaged neighborhoods.
背景
社会经济条件较差的社区特别容易受到与热相关的疾病的影响。我们旨在研究热脆弱性指数（HVI）与急性缺血性脑卒中（AIS）严重程度之间的关系，HVI 是一种已确立的用于衡量与热相关的死亡风险的社区水平指标。
方法
我们对 2012 年至 2021 年间综合卒中中心连续收治的 AIS 患者进行了回顾性分析。根据国立卫生研究院卒中量表（NIHSS），入院时确定卒中严重程度。从电子健康记录中提取人口统计学、社会经济和临床特征。使用居住邮政编码分配 HVI 状况。进行多变量逻辑回归分析。
结果
在 3429 例 AIS 患者中，有 1123 例（32.8%）来自高 HVI（评分 4-5）社区，868 例（25.3%）有严重卒中（NIHSS 评分≥10）。在逐步选择的多变量回归模型中，高 HVI 与严重卒中独立相关（调整后的优势比：1.40 [95%置信区间 1.16-1.69]）。
结论
高 HVI 与严重卒中之间的关联强调了针对社会经济弱势社区的政策干预措施以减轻与热相关的疾病的重要性。
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