Seasonal variation in the occurrence of ischemic stroke: A meta-analysis
Seasonal variation in the occurrence of ischemic stroke: A meta-analysis
复制标题
DOI：
10.1007/s10653-019-00265-y
复制
发表时间：
2019-10-01
影响因子：
4.2
通讯作者：
Zhou, Muke
中科院分区：
文献类型：
--
作者：
Li, Yanbo;Zhou, Zhiwei;Zhou, Muke
中风被证明与季节变化有关。然而，相关研究并不一致。为了更好地了解缺血性卒中（IS）患者的季节性影响规律，我们进行了这项荟萃分析。我们系统地检索了Pubmed、Web of science和Embase中1980年1月1日至2017年11月1日的相关观察性研究，并使用英文。本研究纳入的患者为患有IS的成年人。使用Stata 12.0版软件汇总有用数据并计算发生率比（IRR）及其95%置信区间（CI）。我们还进行了异质性和敏感性分析，并评估了发表偏倚。33项观察性研究（涉及234，196名受试者）被纳入荟萃分析。夏季和12月分别作为参考。计算的IRR显示：IRR冬季1.05（95% CI 1.04-1.07），IRR秋季1.03（95% CI 1.02-1.04），IRR春季1.02（95% CI 1.01-1.03）。术后12个月间差异无统计学意义。还对Koppen分类进行了分层分析。发现研究间异质性;然而，预定义的分层分析和荟萃回归不能降低这种异质性。我们的荟萃分析显示，在整个研究中，季节性差异很小。按照Koppen气候分类分层后，冷月份和热月份都可能是IS的高风险月份。因此，可以提供风险患者管理的环境设置的基本原理。需要进行更多的具体评估研究，以进一步进行全面调查。
Stroke was demonstrated to correlate with seasonal variation. However, the relevant studies were incongruous. To better understand the rules of seasonal impact on ischemic stroke (IS) patients, we performed this meta-analysis. We systematically searched relevant observational studies in Pubmed, Web of science and Embase from January 1, 1980, to November 1, 2017, in English. Patients included in this study were adults who suffered from IS. Stata version 12.0 software was used to pool useful data and calculate incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). We also performed heterogeneity and sensitivity analyses and evaluated publication bias. Thirty-three observational studies involving 234,196 participants were incorporated into the meta-analysis. Summer and December were regarded as reference, respectively. The IRRs were calculated showing: IRRWinter 1.05 (95% CI 1.04-1.07), IRRAutumn 1.03 (95% CI 1.02-1.04), IRRSpring 1.02 (95% CI 1.01-1.03). No obvious difference existed among 12 months. Stratified analyses on Koppen classification were also conducted. Between-study heterogeneity was discovered; however, predefined stratified analyses and meta-regression could not reduce this heterogeneity. Our meta-analysis has revealed very little seasonal variation in the overall study. Both cold and hot months may be high risky for IS after stratified by Koppen Climate Classification. Thus, a rationale to environmental setting of risky patient management could be provided. More studies with specific assessments are warranted for further comprehensive investigation.