Association between Heat Vulnerability Index and Stroke Severity.

3区综合性期刊 International Journal of Environmental Research and Public Health Pub Date : 2024-08-20 DOI:10.3390/ijerph21081099

Jason J Wang, Jeffrey M Katz, Maria X Sanmartin, Liron D Sinvani, Jason J Naidich, Elizabeth Y Rula, Pina C Sanelli

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Abstract

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.

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热脆弱指数与中风严重程度之间的关系

背景：社会经济条件较差的社区尤其容易患上与高温有关的疾病。我们旨在研究热脆弱指数（HVI）与急性缺血性中风（AIS）严重程度之间的关系：我们对 2012 年至 2021 年间一家综合卒中中心连续收治的 AIS 患者进行了回顾性分析。入院时根据美国国立卫生研究院卒中量表（NIHSS）定义卒中严重程度。人口、社会经济和临床特征均从电子健康记录中提取。HVI 状态根据居住地邮政编码进行分配。进行了多变量逻辑回归分析：在 3429 例 AIS 住院患者中，1123 例（32.8%）来自高 HVI（4-5 分）社区，868 例（25.3%）为重度卒中（NIHSS 评分≥ 10 分）。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（调整后的比值比：1.40 [95% 置信区间 1.16-1.69]）：结论：高 HVI 与严重中风之间的关联强调了有针对性地采取政策干预措施以减轻社会经济条件较差的社区中与热有关的疾病的重要性。

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 Environmental Research and Public Health ENVIRONMENTAL SCIENCES-

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14422

期刊介绍： International Journal of Environmental Research and Public Health (IJERPH) (ISSN 1660-4601) is a peer-reviewed scientific journal that publishes original articles, critical reviews, research notes, and short communications in the interdisciplinary area of environmental health sciences and public health. It links several scientific disciplines including biology, biochemistry, biotechnology, cellular and molecular biology, chemistry, computer science, ecology, engineering, epidemiology, genetics, immunology, microbiology, oncology, pathology, pharmacology, and toxicology, in an integrated fashion, to address critical issues related to environmental quality and public health. Therefore, IJERPH focuses on the publication of scientific and technical information on the impacts of natural phenomena and anthropogenic factors on the quality of our environment, the interrelationships between environmental health and the quality of life, as well as the socio-cultural, political, economic, and legal considerations related to environmental stewardship and public health. The 2018 IJERPH Outstanding Reviewer Award has been launched! This award acknowledge those who have generously dedicated their time to review manuscripts submitted to IJERPH. See full details at http://www.mdpi.com/journal/ijerph/awards.