Yang Zihan, Wei Yuchen, Jiang Xiaoting, Li Conglu, Lin Guozhang, Wang Yawen, Chong Ka Chun
Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China.
Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
Int J Biometeorol. 2025 May;69(5):963-973. doi: 10.1007/s00484-025-02870-2. Epub 2025 Mar 20.
Despite the significant adverse health effects and economic burden of stroke inpatients, there has been a paucity of research specifically analyzing and quantifying the association between meteorological factors, air pollutants, influenza infection, and stroke admissions. This study assessed the impact of environmental factors and influenza activity on stroke admissions in Hong Kong from 1998 to 2019, utilizing population-based records. We employed the number of weekly stroke admissions as the primary outcome measure and matched the number with meteorological factors and air pollutant concentrations. Strain-specific influenza-like illness-positive (ILI+) rates were used as a proxy indicator of influenza activity. A quasi-Poisson generalized additive model in combination with a distributed-lag non-linear model (DLNM) was employed to elucidate the relationship of interest. Over the 22-year period, a total of 1,170,882 stroke-related admissions were recorded in Hong Kong. The cumulative adjusted relative risk (ARR) of stroke admission was significantly increased (cumulative ARR = 1.106, 95% CI, 1.069-1.143) at the 5th percentile of temperature (i.e., 15.08 °C) compared with the median reference level. Using zero as the reference value, the cumulative adjusted relative risks of stroke admission were 1.030 (95% CI, 1.018-1.042) at the 95th percentile of ILI + A/H1N1 rate, and 1.022 (95% CI, 1.007-1.038) at the 95th percentile of ILI + total rate. In conclusion, cold weather and influenza infection are risk factors to stroke admissions. Public health strategies for preventing stroke should be considered such as advocating influenza vaccination programmes during winter.
尽管中风住院患者会产生严重的健康不良影响和经济负担，但专门分析和量化气象因素、空气污染物、流感感染与中风入院之间关联的研究却很匮乏。本研究利用基于人群的记录，评估了1998年至2019年环境因素和流感活动对香港中风入院情况的影响。我们将每周中风入院人数作为主要结局指标，并将其与气象因素和空气污染物浓度进行匹配。特定毒株的流感样疾病阳性（ILI+）率被用作流感活动的替代指标。采用准泊松广义相加模型结合分布滞后非线性模型（DLNM）来阐明感兴趣的关系。在这22年期间，香港共记录了1170882例与中风相关的入院病例。与中位数参考水平相比，在温度第5百分位数（即15.08°C）时，中风入院的累积调整相对风险（ARR）显著增加（累积ARR = 1.106，95%置信区间，1.069 - 1.143）。以零作为参考值，在ILI + A/H1N1率第95百分位数时，中风入院的累积调整相对风险为1.030（95%置信区间，1.018 - 1.042），在ILI + 总率第95百分位数时为1.022（95%置信区间，1.007 - 1.038）。总之，寒冷天气和流感感染是中风入院的危险因素。应考虑采取预防中风的公共卫生策略，如在冬季倡导流感疫苗接种计划。
