Seasonal Impact of Diurnal Temperature Range on Intracerebral Hemorrhage in Middle-aged and Elderly People in Central China

Overview

Journal Epidemiol Health

Specialty Public Health

Date 2024 Jun 20

PMID 38901828

Authors

Shiwen Wang

Jinyu Yin

Hao Zhou

Jingmin Lai

Guizhen Xiao

Zhuoya Tong

Jing Deng

Fang Yang

Qianshan Shi

Jingcheng Shi

Affiliations

Soon will be listed here.

Abstract

Objectives: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults.

Methods: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model.

Results: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period.

Conclusions: The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

References

Yang J, Zhou M, Li M, Yin P, Wang B, Pilot E . Diurnal temperature range in relation to death from stroke in China. Environ Res. 2018; 164:669-675. DOI: 10.1016/j.envres.2018.03.036. View

Alimohammadi E, Bagheri S, Mardanpour P, Moradi F, Arjmandnia F, Esmaeili N . Baseline neutrophil-lymphocyte ratio can be associated with hematoma expansion in patients with intracerebral hemorrhage: a retrospective observational study. BMC Neurosci. 2022; 23(1):18. PMC: 8957183. DOI: 10.1186/s12868-022-00705-z. View

Krishnamurthi R, Ikeda T, Feigin V . Global, Regional and Country-Specific Burden of Ischaemic Stroke, Intracerebral Haemorrhage and Subarachnoid Haemorrhage: A Systematic Analysis of the Global Burden of Disease Study 2017. Neuroepidemiology. 2020; 54(2):171-179. DOI: 10.1159/000506396. View

Ma P, Zhou J, Wang S, Li T, Fan X, Fan J . Differences of hemorrhagic and ischemic strokes in age spectra and responses to climatic thermal conditions. Sci Total Environ. 2019; 644:1573-1579. DOI: 10.1016/j.scitotenv.2018.07.080. View

Grundtvig J, Ovesen C, Steiner T, Carcel C, Gaist D, Christensen L . Sex-Differences in Oral Anticoagulant-Related Intracerebral Hemorrhage. Front Neurol. 2022; 13:832903. PMC: 8927802. DOI: 10.3389/fneur.2022.832903. View

Liebetrau M, Steen B, Skoog I . Stroke in 85-year-olds: prevalence, incidence, risk factors, and relation to mortality and dementia. Stroke. 2003; 34(11):2617-22. DOI: 10.1161/01.STR.0000094420.80781.A9. View

Tian Y, Liu H, Si Y, Cao Y, Song J, Li M . Association between temperature variability and daily hospital admissions for cause-specific cardiovascular disease in urban China: A national time-series study. PLoS Med. 2019; 16(1):e1002738. PMC: 6349307. DOI: 10.1371/journal.pmed.1002738. View

Hankey G . Secondary stroke prevention. Lancet Neurol. 2013; 13(2):178-94. DOI: 10.1016/S1474-4422(13)70255-2. View

Lichtman J, Leifheit-Limson E, Jones S, Wang Y, Goldstein L . Average Temperature, Diurnal Temperature Variation, and Stroke Hospitalizations. J Stroke Cerebrovasc Dis. 2016; 25(6):1489-94. DOI: 10.1016/j.jstrokecerebrovasdis.2016.02.037. View

10.

Estol C . Is breathing our polluted air a risk factor for stroke?. Int J Stroke. 2019; 14(4):340-350. DOI: 10.1177/1747493019832999. View

11.

Chu S, Cox M, Fonarow G, Smith E, Schwamm L, Bhatt D . Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States. J Am Heart Assoc. 2018; 7(22):e010020. PMC: 6404452. DOI: 10.1161/JAHA.118.010020. View

12.

Smajlovic D . Strokes in young adults: epidemiology and prevention. Vasc Health Risk Manag. 2015; 11:157-64. PMC: 4348138. DOI: 10.2147/VHRM.S53203. View

13.

Tian Y, Liu H, Zhao Z, Xiang X, Li M, Juan J . Association between ambient air pollution and daily hospital admissions for ischemic stroke: A nationwide time-series analysis. PLoS Med. 2018; 15(10):e1002668. PMC: 6171821. DOI: 10.1371/journal.pmed.1002668. View

14.

Olie V, Grave C, Tuppin P, Duloquin G, Bejot Y, Gabet A . Patients Hospitalized for Ischemic Stroke and Intracerebral Hemorrhage in France: Time Trends (2008-2019), In-Hospital Outcomes, Age and Sex Differences. J Clin Med. 2022; 11(6). PMC: 8949281. DOI: 10.3390/jcm11061669. View

15.

Cheng J, Xu Z, Zhu R, Wang X, Jin L, Song J . Impact of diurnal temperature range on human health: a systematic review. Int J Biometeorol. 2014; 58(9):2011-24. DOI: 10.1007/s00484-014-0797-5. View

16.

Anadani M, Qureshi A, Menacho S, Grandhi R, Yaghi S, Jumaa M . Race/ethnicity and response to blood pressure lowering treatment after intracerebral hemorrhage. Eur Stroke J. 2022; 6(4):343-348. PMC: 8948521. DOI: 10.1177/23969873211046116. View

17.

Lian H, Ruan Y, Liang R, Liu X, Fan Z . Short-Term Effect of Ambient Temperature and the Risk of Stroke: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2015; 12(8):9068-88. PMC: 4555265. DOI: 10.3390/ijerph120809068. View

18.

Guzik A, Bushnell C . Stroke Epidemiology and Risk Factor Management. Continuum (Minneap Minn). 2017; 23(1, Cerebrovascular Disease):15-39. DOI: 10.1212/CON.0000000000000416. View

19.

Foster L, Robinson L, Yeatts S, Conwit R, Shehadah A, Lioutas V . Effect of Deferoxamine on Trajectory of Recovery After Intracerebral Hemorrhage: A Post Hoc Analysis of the i-DEF Trial. Stroke. 2022; 53(7):2204-2210. PMC: 9246960. DOI: 10.1161/STROKEAHA.121.037298. View

20.

Wang W, Jiang B, Sun H, Ru X, Sun D, Wang L . Prevalence, Incidence, and Mortality of Stroke in China: Results from a Nationwide Population-Based Survey of 480 687 Adults. Circulation. 2017; 135(8):759-771. DOI: 10.1161/CIRCULATIONAHA.116.025250. View