Seasonal and monthly variability in the incidence of venous thromboembolism A systematic review and a meta-analysis of the literature
Seasonal and monthly variability in the incidence of venous thromboembolism A systematic review and a meta-analysis of the literature
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DOI：
10.1160/th11-02-0116
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发表时间：
2011-09-01
影响因子：
6.7
通讯作者：
Manfredini, Roberto
中科院分区：
文献类型：
--
作者：
Dentali, Francesco;Ageno, Walter;Manfredini, Roberto
许多研究表明，心脑血管事件的发生呈现出季节和月份的变化。静脉血栓栓塞症（VTE）发病率的季节和月份变化的证据则更具争议性。我们对文献进行了系统综述和荟萃分析，以评估这种疾病是否存在亚日节律。我们检索了截至2010年1月的MEDLINE和EMBASE数据库，对VTE发病率的月份和季节变化进行了分析。我们纳入了分析深静脉血栓形成（DVT）和/或肺栓塞（PE）发病率的季节或月份聚集情况且对VTE有客观诊断的研究。两位作者独立审查并提取数据。共纳入17项研究，涉及约35000名患者。12项研究分析了VTE的季节变化，10项研究分析了VTE的月份变化。我们的结果显示，VTE在冬季的发病率显著增加（卡方值146.04，p<0.0001），在12月达到峰值（比值比[OR] 1.31，95%置信区间[CI] 1.21 - 1.42）。在夏季，VTE的发病率显著降低（卡方值102.88，p<0.0001），在6月达到最低点（OR 0.78，95%CI 0.71 - 0.86）。对于月份变化，我们发现1月（OR 1.26，95%CI 1.16 - 1.37）和12月（OR 1.24，95%CI 1.14 - 1.35）的发病率较高，而6月（OR 0.79，95%CI 0.72 - 0.87）和7月（OR 0.81，95%CI 0.73 - 0.90）的发病率较低。我们的研究结果表明，VTE的发病率存在显著的季节和月份变化，冬季和12月、1月的发病率较高，夏季和6月、7月的发病率较低。这些结果可能对VTE的预防和治疗具有重要意义。
Many studies showed that the occurrence of cardiovascular and cerebrovascular events exhibits a seasonal and monthly variation. Evidences of a seasonal and monthly variation in the incidence of venous thromboennbolism (VTE) are more conflicting. We conducted a systematic review and a meta-analysis of the literature to assess the presence of an infradian rhythm of this disease. MEDLINE and EMBASE databases were searched up to January 2010. Monthly and seasonal variation in the incidence of VTE were analysed. We included studies analysing seasonal or monthly aggregation in the incidence of deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) with an objective diagnosis of VTE. Two authors independently reviewed and extracted data. Seventeen studies for a total of about 35,000 patients were included. Twelve studies analysed the seasonal var ation and 10 studies the monthly variation of VIE. Our results showed a significantly increased incidence of VTE in winter (chi-square 146.04, p