Association Between Meteorological Factors and the Rupture of Intracranial Aneurysms
Association Between Meteorological Factors and the Rupture of Intracranial Aneurysms
复制标题
气象因素与颅内动脉瘤破裂的关系
DOI：
10.1161/jaha.119.012205
复制
发表时间：
2019-09-03
影响因子：
5.4
通讯作者：
Luo, Muyun
中科院分区：
文献类型：
--
作者：
Li, MeiHua;Hu, Si;Luo, Muyun
背景气象因素和形态因素都是预测颅内动脉瘤破裂的重要因素。本研究探讨了气象因素与动脉瘤性蛛网膜下腔出血（aSAH）之间的关系。此外，还评估了这些高风险气象条件下破裂和未破裂动脉瘤之间的形态差异。方法与结果对1751例aSAH患者2124个颅内动脉瘤的记录进行回顾性分析。根据每日气象数据，使用 Spearman 等级相关分析来评估发生 aSAH 的风险。使用单向方差分析检验分析形态参数，并使用多变量逻辑回归分析进一步检查显着参数（P<0.05）。日aSAH发病率与日平均、最高、最低气温呈显着负相关（P<0.001），与日平均大气压呈显着正相关（P<0.001）。此外，还对 58 名患有多发性动脉瘤的患者进行了评估以确定形态差异。动脉瘤大小、颈宽、长度、高度、宽度、载瘤动脉直径、动脉瘤形状、纵横比、尺寸比和瓶颈因子的平均值存在显着差异（P<0.05）。多变量Logistic回归分析显示，纵横比（β=1.277，比值比=3.585，95% CI，1.588~8.090；P=0.002）是动脉瘤破裂的独立危险因素。受试者工作特征曲线分析表明，动脉瘤破裂阈值尺寸为3.45 mm，纵横比为1.05。结论 较低的日平均、最高和最低气温以及较高的日平均气压与 aSAH 发生率增加有关。另外，在这些气象条件下，用于预测动脉瘤破裂的动脉瘤尺寸和纵横比阈值可能较低。
Background Both meteorological factors and morphological factors are important factors to predict intracranial aneurysm rupture. This study investigated the relationship between meteorological factors and aneurysmal subarachnoid hemorrhage (aSAH). Additionally, the morphological differences between ruptured and unruptured aneurysms under these high‐risk meteorological conditions were assessed. Methods and Results The records of 1751 patients with aSAH with 2124 intracranial aneurysms were retrospectively analyzed. Spearman rank correlation analysis was used to assess the risks of incident aSAH on the basis of daily meteorological data. Morphological parameters were analyzed using 1‐way ANOVA tests, and significant parameters (P<0.05) were further examined using a multivariable logistic regression analysis. Daily aSAH incidence had significant negative correlations with daily mean, maximum, and minimum temperature (P<0.001) and a significant positive correlation with daily mean atmospheric pressure (P<0.001). Additionally, 58 patients with multiple aneurysms were assessed to determine morphological differences. There were significant differences in the mean values for aneurysm size, neck width, length, height, width, parent artery diameter, shape of the aneurysm, aspect ratio, size ratio, and bottleneck factor (P<0.05). The multivariable logistic regression analysis showed that aspect ratio (β=1.277, odds ratio=3.585, 95% CI, 1.588–8.090; P=0.002) was an independent risk factor for aneurysm rupture. Receiver operating characteristic curve analysis indicated that the ruptured aneurysm threshold of size was 3.45 mm and aspect ratio was 1.05. Conclusions Lower daily mean, maximum, and minimum temperatures and a higher daily mean atmospheric pressure were associated with an increased rate of aSAH. Additionally, under these meteorological conditions, the aneurysm size and aspect ratio thresholds for predicting rupture of an aneurysm may be lower.