Seasonal Variations in Stroke Occurrence.

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY Neuroepidemiology Pub Date : 2024-07-22 DOI:10.1159/000540056

Vincent Brissette, Moira K Kapral, Bing Yu, Jiming Fang, Tomi Odugbemi, Michel Shamy, Robert Fahed, Dar Dowlatshahi, Sophia Gocan, Isabelle Martineau

{"title":"Seasonal Variations in Stroke Occurrence.","authors":"Vincent Brissette, Moira K Kapral, Bing Yu, Jiming Fang, Tomi Odugbemi, Michel Shamy, Robert Fahed, Dar Dowlatshahi, Sophia Gocan, Isabelle Martineau","doi":"10.1159/000540056","DOIUrl":null,"url":null,"abstract":"Background: Understanding seasonal variations in stroke can help stakeholders identify underlying causes in seasonal trends, and tailor resources appropriately to times of highest needs. We sought to evaluate the seasonal occurrence of stroke and its subtypes.Methods: We conducted a retrospective cohort study using administrative data from January 1st, 2003, to December 31st, 2017, in Ontario, Canada's most populous province. We evaluated seasonal variations in stroke occurrence by subtype, via age/sex standardized rates and adjusted rate ratios using Poisson regressions. In those with stroke, we evaluated 30-day case fatality risks by season, adjusted for age, sex, stroke type, and comorbid conditions, and then used Cox proportional hazard models to estimate the effect of season on the fatality. The administrative data used in this study were from the Canadian Institute for Health Information's Discharge Abstract Database, the National Ambulatory Care Reporting System Database, the Ontario Registered Persons Database, and the 2006 and 2011 Canada Census and linked administrative databases.Results: During our study period, we observed 394,145 strokes or TIA events, with a decrease in monthly hospitalization/emergency department visits per 100,000 people between January 2003 and December 2017 from 24.22 to 17.43. Compared to the summer, overall stroke occurrence was similar in the spring but slightly lower in the fall (adjusted rate ratio [aRR] 0.97, 95% confidence interval [CI] 0.96-0.98) and winter (aRR 0.94, 95% CI: 0.94-0.95). There were minor variations by stroke subtype. Winter was associated with the highest risk of stroke case fatality compared to the summer (12.4% vs. 11.4%, adjusted hazard ratio 1.10, 95% CI: 1.07-1.13).Conclusions: We found seasonal variations in stroke occurrence and case fatality, although the absolute differences were small. Further work is needed to better understand how environmental or meteorological factors might affect stroke risk.","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-10"},"PeriodicalIF":3.2000,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroepidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000540056","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Understanding seasonal variations in stroke can help stakeholders identify underlying causes in seasonal trends, and tailor resources appropriately to times of highest needs. We sought to evaluate the seasonal occurrence of stroke and its subtypes.

Methods: We conducted a retrospective cohort study using administrative data from January 1st, 2003, to December 31st, 2017, in Ontario, Canada's most populous province. We evaluated seasonal variations in stroke occurrence by subtype, via age/sex standardized rates and adjusted rate ratios using Poisson regressions. In those with stroke, we evaluated 30-day case fatality risks by season, adjusted for age, sex, stroke type, and comorbid conditions, and then used Cox proportional hazard models to estimate the effect of season on the fatality. The administrative data used in this study were from the Canadian Institute for Health Information's Discharge Abstract Database, the National Ambulatory Care Reporting System Database, the Ontario Registered Persons Database, and the 2006 and 2011 Canada Census and linked administrative databases.

Results: During our study period, we observed 394,145 strokes or TIA events, with a decrease in monthly hospitalization/emergency department visits per 100,000 people between January 2003 and December 2017 from 24.22 to 17.43. Compared to the summer, overall stroke occurrence was similar in the spring but slightly lower in the fall (adjusted rate ratio [aRR] 0.97, 95% confidence interval [CI] 0.96-0.98) and winter (aRR 0.94, 95% CI: 0.94-0.95). There were minor variations by stroke subtype. Winter was associated with the highest risk of stroke case fatality compared to the summer (12.4% vs. 11.4%, adjusted hazard ratio 1.10, 95% CI: 1.07-1.13).

Conclusions: We found seasonal variations in stroke occurrence and case fatality, although the absolute differences were small. Further work is needed to better understand how environmental or meteorological factors might affect stroke risk.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

中风发生率的季节性变化

背景了解中风的季节性变化有助于相关人员识别季节性趋势的根本原因，并根据需求最大的时期适当调整资源。我们试图评估中风及其亚型的季节性发生率。方法我们利用加拿大人口最多的省份安大略省 2003 年 1 月 1 日至 2017 年 12 月 31 日的行政数据开展了一项回顾性队列研究。我们通过年龄/性别标准化比率和泊松回归调整比率，评估了各亚型中风发生率的季节性变化。对于中风患者，我们按季节评估了 30 天病例死亡风险，并对年龄、性别、中风类型和合并症进行了调整，然后使用 Cox 比例危险模型来估计季节对死亡的影响。本研究使用的管理数据来自加拿大卫生信息研究所的出院摘要数据库（DAD）、国家非住院医疗报告系统（NACRS）数据库、安大略省注册人员数据库以及 2006 年和 2011 年加拿大人口普查和相关管理数据库。结果在研究期间，我们观察到 394,145 起中风或 TIA 事件，2003 年 1 月至 2017 年 12 月期间，每 10 万人中每月住院/急诊就诊人数从 24.22 人降至 17.43 人。与夏季相比，春季的总体中风发生率相似，但秋季（调整后相对风险（aRR）为 0.97，95% 置信区间（CI）为 0.96 至 0.98）和冬季（aRR 为 0.94，95% 置信区间（CI）为 0.94 至 0.95）略低。中风亚型略有不同。与夏季相比，冬季中风死亡风险最高（12.4% 对 11.4%，调整后危险比 1.10，95% CI 1.07 至 1.13）。结论我们发现中风发生率和病死率存在季节性变化，但绝对差异很小。要更好地了解环境或气象因素如何影响中风风险，还需要进一步的工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Neuroepidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

9.90

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Neuroepidemiology'' is the only internationally recognised peer-reviewed periodical devoted to descriptive, analytical and experimental studies in the epidemiology of neurologic disease. The scope of the journal expands the boundaries of traditional clinical neurology by providing new insights regarding the etiology, determinants, distribution, management and prevention of diseases of the nervous system.