Modification effects of immigration status and comorbidities on associations of heat and heatwave with stroke morbidity.

IF 6.3 2区医学 Q1 CLINICAL NEUROLOGY International Journal of Stroke Pub Date : 2024-10-01 Epub Date: 2024-07-31 DOI:10.1177/17474930241263725

Chenlu Yang, Yike Li, Cunrui Huang, Yonglin Hou, Dandan Chu, Junzhe Bao

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引用次数: 0

Abstract

Background: Heat and heatwave have been associated with stroke morbidity, but it is still unclear whether immigrants from different geographic regions and patients with comorbidity are more vulnerable to heat and heatwave.

Methods: Time-stratified case-crossover design combined with generalized additive quasi-Poisson models were used to quantify the relative risks (RRs) of heat and heatwave on first-ever stroke morbidity during 0-7 lag days. Attributable fractions (AFs) were estimated to assess the first-ever stroke morbidity burden due to heat and heatwave. Stratified analyses for sex, age, disease subtypes, resident characteristics, and comorbidity type were performed to identify potential modification effects.

Results: Heat and heatwave were associated with first-ever stroke morbidity, with the AF of 2.535% (95% empirical confidence interval (eCI) = 0.748, 4.205) and 2.409% (95% confidence interval (CI) = 1.228, 3.400), respectively. Among northern and southern immigrants, the AF for heat was 2.806% (0.031, 5.069) and 2.798% (0.757, 4.428), respectively, and the AF for heatwave was 2.918% (0.561, 4.618) and 2.387% (1.174, 3.398), respectively, but the effects of both on natives were statistically insignificant. Among patients with hypertension, dyslipidemia, or diabetes, the AF for heat was 3.318% (1.225, 5.007), 4.237% (1.037, 6.770), and 4.860% (1.171, 7.827), respectively, and the AF for heatwave was 2.960% (1.701, 3.993), 2.771% (0.704, 4.308), and 2.652% (0.653, 4.185), respectively. However, the effects of both on patients without comorbidity were statistically insignificant.

Conclusion: Heat and heatwave are associated with an increased risk of first-ever stroke morbidity among immigrants and those with comorbid hypertension, dyslipidemia, or diabetes, with the effects primarily due to non-native individuals.

Data access statement: The author(s) are not authorized to share the data.

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移民身份和合并症对高温和热浪与中风发病率相关性的修正效应。

背景：高温和热浪与中风发病率有关：高温和热浪与中风发病率有关，但来自不同地理区域的移民和合并症患者是否更容易受到高温和热浪的影响仍不清楚：方法：采用时间分层病例交叉设计结合广义加性准泊松模型来量化高温和热浪对 0-7 滞后天首次发病中风的相对风险（RR）。估算了可归因分数（AF），以评估高温和热浪导致的首次发病中风负担。对性别、年龄、疾病亚型、居民特征和合并症类型进行了分层分析，以确定潜在的修正效应：结果：炎热和热浪与首次中风发病率相关，其AF值分别为2.535%（95% eCI：0.748, 4.205）和2.409%（95% CI：1.228, 3.400）。在北方和南方移民中，高温的自动平均血脂指数分别为 2.806% (0.031, 5.069) 和 2.798% (0.757, 4.428)，热浪的自动平均血脂指数分别为 2.918% (0.561, 4.618) 和 2.387% (1.174, 3.398)，但两者对本地人的影响在统计学上并不显著。在高血压、血脂异常或糖尿病患者中，热量的 AF 为 3.318%（1.225，5.007）、4.237%（1.037，6.770）和 4.860%（1.171，7.827），热浪的AF分别为2.960%（1.701，3.993）、2.771%（0.704，4.308）和2.652%（0.653，4.185）。然而，两者对无合并症患者的影响在统计学上并不显著：结论：高温和热浪与移民及合并高血压、血脂异常或糖尿病的人群首次中风发病风险增加有关，其影响主要来自非本地人。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Stroke 医学-外周血管病

CiteScore

13.90

自引率

6.00%

发文量

132

审稿时长

6-12 weeks

期刊介绍： The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.