The effects of heat stress and its effect modifiers on stroke hospitalizations in Allegheny County, Pennsylvania
The effects of heat stress and its effect modifiers on stroke hospitalizations in Allegheny County, Pennsylvania
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DOI：
10.1007/s00420-013-0897-2
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发表时间：
2014-07-01
影响因子：
3
通讯作者：
Xu, Xiaohui
中科院分区：
文献类型：
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作者：
Ha, Sandie;Talbott, Evelyn O.;Xu, Xiaohui
众所周知，高温会增加许多健康终点的风险。然而，很少有研究调查它对中风的影响。本病例交叉研究的目的是调查高温及其影响调节剂对宾夕法尼亚州阿勒格尼县卒中住院风险的影响。我们获得了1994年至2000年阿勒格尼县65岁及以上成年人首次中风住院的数据和温暖季节（5月至9月）的每日气象信息。采用条件多元logistic回归，研究高温天数（温度大于95百分位的任何一天）和热浪天数（至少连续两个高温天数）对卒中住院风险的影响。高热与年龄、中风类型和性别之间的潜在相互作用也被检查。在调整重要协变量后，高温日和滞后2天的热浪与卒中住院风险增加显著相关（OR分别为1.121,95% CI 1.013-1.242； OR为1.173,95% CI 1.047-1.315）。此外，在事件发生前的4天窗口内有两天或更多的热浪天，与此期间没有热浪天相比，风险也显著增加（or 1.119, 95% CI 1.004, 1.246）。高温对缺血性中风、男性和80岁以上受试者的影响更为显著。我们的研究表明，高温可能对中风有不利影响，某些亚群可能特别容易受到高温的影响。
Heat has been known to increase the risk of many health endpoints. However, few studies have examined its effects on stroke. The objective of this case-crossover study is to investigate the effects of high heat and its effect modifiers on the risk of stroke hospitalization in Allegheny County, Pennsylvania.We obtained data on first stroke hospitalizations among adults ages 65 and older and daily meteorological information during warm seasons (May-September) from 1994 to 2000 in Allegheny County, Pennsylvania. Using conditional multiple logistic regressions, the effects of heat days (any day with a temperature greater than the 95th percentile) and heat wave days (at least two continuous heat days) on the risk of stroke hospitalization were investigated. The potential interactions between high heat and age, type of stroke, and gender were also examined.Heat day and heat wave at lag-2 day were significantly associated with an increased risk for stroke hospitalization (OR 1.121, 95 % CI 1.013-1.242; OR 1.173, 95 % CI 1.047-1.315, respectively) after adjusting for important covariates. In addition, having two or more heat wave days within the 4 day window prior to the event was also significantly associated with an increased risk (OR 1.119, 95 % CI 1.004, 1.246) compared to having no heat wave days during the period. The effect of high heat on stroke was more significant for ischemic stroke, men, and subjects ages 80 years or older.Our study suggests that high heat may have adverse effects on stroke and that some subgroups may be particularly susceptible to heat.