Winter excess in hospital admissions, in-patient mortality and length of acute hospital stay in stroke: A hospital database study over six seasonal years in Norfolk, UK
Winter excess in hospital admissions, in-patient mortality and length of acute hospital stay in stroke: A hospital database study over six seasonal years in Norfolk, UK
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DOI：
10.1159/000098550
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发表时间：
2007-01-01
影响因子：
5.7
通讯作者：
Fulcher, Robert A.
中科院分区：
文献类型：
--
作者：
Myint, Phyo K.;Vowler, Sarah L.;Fulcher, Robert A.
背景：一些研究已经研究了中风的发病率和死亡率与季节的关系。然而，证据是相互矛盾的，部分原因是人群的差异(社区与医院为基础)，以及研究之间的气候条件。此外，他们可能没有考虑到研究人群的年龄、性别和中风类型。我们假设，年龄、性别和中风类型是是否存在与中风相关的冬季过剩发病率和死亡率的主要决定因素。方法：我们分析了来自英国诺福克的一个基于医院的卒中登记，以检验我们先前的假设。使用柯文的方法，我们按(1)季节性年份和(2)患者年龄和中风亚型的四分位数进行了分层性别分析，并计算了冬季入院人数、住院死亡人数和急性住院时间。结果：共5,481例患者(男性占45%)。年龄17~105岁(中位数78岁)。与非冬季相比，冬季的入院人数、死亡人数和急性住院时间似乎超出了总入院人数的3/100,000(男性冬季过剩指数为3.4%，女性为7.6%)和1/100,000例死亡(冬季过剩指数为4.7%和8.6%)。非出血性中风的老年患者主要是这种过剩的原因。如果我们的发现在整个英格兰和威尔士重复，据估计，在目前约6000万人口中，每年冬天都有1700人超额入院，600人额外住院死亡，24500天额外的急性住院日与中风有关。结论：应进一步研究与卒中相关的冬季发病率和死亡率过高的决定因素。这可能会在未来提供有效的预防策略，从而降低发病率和死亡率。版权所有(C)2007 S.Karger AG，巴塞尔。
Background: Several studies have examined the incidence and mortality of stroke in relation to season. However, the evidence is conflicting partly due to variation in the populations (community vs. hospital-based), and in climatic conditions between studies. Moreover, they may not have been able to take into account the age, sex and stroke type of the study population. We hypothesized that the age, sex and type of stroke are major determinants of the presence or absence of winter excess in morbidity and mortality associated with stroke. Methods: We analyzed a hospital-based stroke register from Norfolk, UK to examine our prior hypothesis. Using Curwen's method, we performed stratified sex-specific analyses by (1) seasonal year and (2) quartiles of patients' age and stroke subtype and calculated the winter excess for the number of admissions, in-patient deaths and length of acute hospital stay. Results: There were 5,481 patients (men = 45%). Their ages ranged from 17 to 105 years (median = 78 years). There appeared to be winter excess in hospital admissions, deaths and length of acute hospital stay overall accounting for 3/100,000 extra admissions (winter excess index of 3.4% in men and 7.6% in women) and 1/100,000 deaths (winter excess index of 4.7 and 8.6% in women) due to stroke in winter compared to non-winter periods. Older patients with non-haemorrhagic stroke mainly contribute to this excess. If our findings are replicated throughout England and Wales, it is estimated that there are 1,700 excess admissions, 600 excess in-patient deaths and 24,500 extra acute hospital bed days each winter, related to stroke within the current population of approximately 60 million. Conclusions: Further research should be focused on the determinants of winter excess in morbidity and mortality associated with stroke. This may subsequently reduce the morbidity and mortality by providing effective preventive strategies in future. Copyright (c) 2007 S. Karger AG, Basel.