Seasonality of hypoplastic left heart syndrome in the United States: A 10-year time-series analysis
Seasonality of hypoplastic left heart syndrome in the United States: A 10-year time-series analysis
复制标题
DOI：
10.1016/j.jtcvs.2010.06.060
复制
发表时间：
2011-02-01
影响因子：
6
通讯作者：
Hall, Matthew
中科院分区：
文献类型：
--
作者：
Eghtesady, Pirooz;Brar, Anoop;Hall, Matthew
目的：左心发育不全综合征是一种严重的先天性心脏病，与显著的发病率和死亡率相关。其病因仍然不明，虽然遗传学研究表明复杂的遗传。虽然以前的流行病学研究范围有限，但有关集群介绍的轶事报告表明可能涉及环境因素。本研究的目的是检查季节性和时间模式的左心发育不良综合征出生相比，其他左侧心脏defects in the United States.Methods：我们进行了一项回顾性分析，从1996年至2006年全国各地的儿科医院的儿科健康信息系统住院数据库。分析了每个诊断类别的人群和索引病例模式。流行病学调查是通过时间序列分析，使用Fisher's Kappa检验和Bartlett Kolmogorov-Smirnov检验。结果：左心发育不良综合征存在季节性，而其他左心疾病无季节性。每年都有显著的季节性差异，夏季月份达到高峰，冬季月份达到低谷。季节性与染色体和心外异常的发病率呈负相关，这种异常是最高的中断主动脉弓，它有一个随机的模式presentation.Conclusions：有一个显着的季节性模式，在介绍左心室发育不良综合征，在夏季的优势，在其他左侧心脏疾病的随机模式。进一步的研究是必要的，以确定潜在的环境因素在左心发育不良综合征的影响，如在疾病的季节性模式。（《胸血管外科杂志》2011;141：432-8）
Objective: Hypoplastic left heart syndrome is a major congenital heart defect and is associated with significant morbidity and mortality. Its etiology remains unknown although genetic studies imply complex inheritance. Anecdotal reports of cluster presentations suggest the possible involvement of an environmental component, although previous epidemiologic studies have been of limited scope. The objective of this study was to examine seasonal and temporal patterns of hypoplastic left heart syndrome births compared with other left-sided heart defects in the United States.Methods: We conducted a retrospective analysis of the Pediatric Health Information System inpatient database from pediatric hospitals across the country from 1996 to 2006. Population and index case patterns were analyzed for each diagnostic category. An epidemiologic survey was performed through time-series analyses using Fisher's Kappa test and the Bartlett Kolmogorov-Smirnov test. The existence and strength of seasonality for the left-sided heart defects was quantified by the autoregression R-2.Results: A seasonal occurrence was found in hypoplastic left heart syndrome but not other left-sided heart diseases. Significant seasonal differences occurred each year, with peaks in summer months and troughs in winter months. The seasonality inversely correlated with the incidence of chromosomal and extracardiac anomalies; such anomalies were highest in interrupted aortic arch, which had a random pattern of presentation.Conclusions: There is a significant seasonal pattern in the presentation of hypoplastic left heart syndrome, with preponderance in summer months, in contrast to the random pattern in other left-sided heart diseases. Further studies are warranted to identify the influence of potential environmental factor(s) in hypoplastic left heart syndrome, as seen in diseases with seasonal patterns. (J Thorac Cardiovasc Surg 2011;141:432-8)