Out-of-hospital cardiac arrest attributable to sunshine: a nationwide, retrospective, observational study
Out-of-hospital cardiac arrest attributable to sunshine: a nationwide, retrospective, observational study
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因阳光导致的院外心脏骤停：一项全国性、回顾性、观察性研究
DOI：
10.1093/ehjqcco/qcw056
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Hagihara Akihito
中科院分区：
文献类型：
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作者：
Onozuka Daisuke;Hagihara Akihito
目的探讨非最佳日照时数对院外心脏骤停（OHCA）的人群归因风险及日日照时数的相对贡献。方法与结果收集日本47个县2005 - 2014年发生的所有OHCA病例的国家登记资料。我们使用泊松回归模型结合分布滞后非线性模型，对日本每个县的日日照时间与OHCA风险之间的关系进行了检验，并对混杂因素进行了调整。使用多变量随机效应荟萃分析，在全国范围内汇总了每个州的估计关联。总共有658 742例假定为心脏来源的OHCA符合我们的纳入标准。最小发病日照时数从冈山的第21百分位到北海道、岐阜和兵库县的第99百分位不等。总体而言，5.78%[95%经验置信区间（eCI）： 3.57 ~ 7.16]的OHCA病例归因于日日照时数。日照时间短（低于最小发病日照时数）的归因比例为4.18% (95% eCI: 2.64 ~ 5.38)，日照时间长（高于最小发病日照时数）的归因比例为1.59% （95% eCI: 0.81 ~ 2.21）。结论日常日照时间是造成OHCA负担的主要原因，且每天日照时间较短的患者OHCA发病较多。我们的研究结果提示，减少OHCA负担的公共卫生努力应考虑日照水平。
AimsTo investigate the population attributable risk of out-of-hospital cardiac arrest (OHCA) from non-optimal sunshine duration and the relative contribution of daily sunshine hours.Methods and ResultsNational registry data of all cases of OHCA occurred between 2005 and 2014 in the 47 Japanese prefectures were obtained. We examined the relationship between daily duration of sunshine and OHCA risk for each prefecture in Japan using a Poisson regression model combined with a distributed lag non-linear model, adjusting for confounding factors. The estimated associations for each prefecture were pooled at the nationwide level using a multivariate random-effects meta-analysis. A total of 658 742 cases of OHCA of presumed cardiac origin met our inclusion criteria. The minimum morbidity sunshine duration varied from the 21st percentile in Okayama to the 99th percentile in Hokkaido, Gifu, and Hyogo. Overall, 5.78% [95% empirical confidence interval (eCI): 3.57–7.16] of the OHCA cases were attributable to daily sunshine duration. The attributable fraction for short sunshine duration (below the minimum morbidity sunshine duration) was 4.18% (95% eCI: 2.64–5.38), whereas that for long sunshine duration (above the minimum morbidity sunshine duration) was 1.59% (95% eCI: 0.81–2.21).ConclusionsDaily sunshine duration was responsible for OHCA burden, and a greater number of OHCA cases occurred in patients who were only exposed to sunshine for short periods of time each day. Our findings suggest that public health efforts to reduce OHCA burden should take sunshine level into account.