New Insights into Weather and Stroke: Influences of Specific Air Masses and Temperature Changes on Stroke Incidence.


Journal

Cerebrovascular diseases (Basel, Switzerland)
ISSN: 1421-9786
Titre abrégé: Cerebrovasc Dis
Pays: Switzerland
ID NLM: 9100851

Informations de publication

Date de publication:
2019
Historique:
received: 18 02 2019
accepted: 01 07 2019
pubmed: 26 7 2019
medline: 6 5 2020
entrez: 26 7 2019
Statut: ppublish

Résumé

Meteorological factors seem to influence stroke incidence, however, the complex association between weather and stroke remains unclear. Possible explanations from the literature do not categorize into subdivisions of ischemic strokes, only have small patient numbers, or refer to a selection of isolated weather elements without investigating weather changes and more. In this exploratory trial, almost 18,000 stroke cases from a single stroke center in Southern Germany were analyzed from 2006 to 2015 and classified into the main subgroups of strokes and subdivisions of ischemic stroke etiologies applying the Trial of Org 10172 in Acute Stroke Treatment classification. For each stroke event, the air mass classification was determined from a subset of 7 air mass categories. Relative excess morbidities were derived for the 7 different air mass categories, taking into account the day of the event and up to 2 and 5 days preceding the stroke event. Statistically significant findings (α ≤0.1) reveal that dry tropical air masses were associated with a lower/higher risk for hemorrhagic (HEM)/macroangiopathic strokes (MAS), respectively. Dry polar air masses were associated with a higher risk for intracerebral bleedings and lower risk for ischemic stroke subtypes. Moist air masses were associated with a reduced incidence of MAS. A strong temperature increase 5 days prior to the event was associated with a lower risk of HEM strokes. Temperature increases were associated with lower risks for MAS and cardio-embolic strokes. Significant temperature decreases were associated with a higher risk of MAS. Temperature effects were dependent on both air masses and temperature changes within 5 days prior to the event and were associated with statistically relevant changes in stroke incidence. Decisive factors such as etiology, age, sex, and risk factors were also taken into account.

Sections du résumé

BACKGROUND/OBJECTIVES
Meteorological factors seem to influence stroke incidence, however, the complex association between weather and stroke remains unclear. Possible explanations from the literature do not categorize into subdivisions of ischemic strokes, only have small patient numbers, or refer to a selection of isolated weather elements without investigating weather changes and more.
METHOD
In this exploratory trial, almost 18,000 stroke cases from a single stroke center in Southern Germany were analyzed from 2006 to 2015 and classified into the main subgroups of strokes and subdivisions of ischemic stroke etiologies applying the Trial of Org 10172 in Acute Stroke Treatment classification. For each stroke event, the air mass classification was determined from a subset of 7 air mass categories. Relative excess morbidities were derived for the 7 different air mass categories, taking into account the day of the event and up to 2 and 5 days preceding the stroke event.
RESULTS
Statistically significant findings (α ≤0.1) reveal that dry tropical air masses were associated with a lower/higher risk for hemorrhagic (HEM)/macroangiopathic strokes (MAS), respectively. Dry polar air masses were associated with a higher risk for intracerebral bleedings and lower risk for ischemic stroke subtypes. Moist air masses were associated with a reduced incidence of MAS. A strong temperature increase 5 days prior to the event was associated with a lower risk of HEM strokes. Temperature increases were associated with lower risks for MAS and cardio-embolic strokes. Significant temperature decreases were associated with a higher risk of MAS.
CONCLUSIONS
Temperature effects were dependent on both air masses and temperature changes within 5 days prior to the event and were associated with statistically relevant changes in stroke incidence. Decisive factors such as etiology, age, sex, and risk factors were also taken into account.

Identifiants

pubmed: 31344703
pii: 000501843
doi: 10.1159/000501843
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

275-284

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Michael Ertl (M)

Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany, michael.ertl@uk-augsburg.de.

Christoph Beck (C)

Institute of Geography, University of Augsburg, Augsburg, Germany.

Benjamin Kühlbach (B)

Institute of Geography, University of Augsburg, Augsburg, Germany.

Jasmin Hartmann (J)

Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany.

Gertrud Hammel (G)

Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Augsburg, Germany.
CK-CARE, Christine Kühne, Center for Allergy and Research and Education, Davos, Switzerland.

Annette Straub (A)

Institute of Geography, University of Augsburg, Augsburg, Germany.

Esther Giemsa (E)

Institute of Geography, University of Augsburg, Augsburg, Germany.

Stefanie Seubert (S)

Institute of Geography, University of Augsburg, Augsburg, Germany.

Andreas Philipp (A)

Institute of Geography, University of Augsburg, Augsburg, Germany.

Claudia Traidl-Hoffmann (C)

Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Augsburg, Germany.
CK-CARE, Christine Kühne, Center for Allergy and Research and Education, Davos, Switzerland.
Outpatient Clinic for Environmental Medicine, University Hospital Augsburg, Augsburg, Germany.

Jens Soentgen (J)

Environmental Science Center, University of Augsburg, Augsburg, Germany.

Jucundus Jacobeit (J)

Institute of Geography, University of Augsburg, Augsburg, Germany.

Markus Naumann (M)

Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany.

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