TY - JOUR
T1 - Temperature and precipitation associate with ischemic stroke outcomes in the United States
AU - Chu, Stacy Y.
AU - Cox, Margueritte
AU - Fonarow, Gregg C.
AU - Smith, Eric E.
AU - Schwamm, Lee
AU - Bhatt, Deepak L.
AU - Matsouaka, Roland A.
AU - Xian, Ying
AU - Sheth, Kevin N.
N1 - Funding Information:
This study was supported by an American Heart Association Young Investigator Database Research Seed Grant (Chu).
Funding Information:
Dr Chu is supported by a Young Investigator Database Research Seed Grant from the American Heart Association. Dr Fonarow reports research support from Patient-Centered Outcomes Research Institute, and is a GWTG-Stroke Steering Committee member, and employee of University of California which has a patent on endovascular devices. Dr Smith reports
Publisher Copyright:
© 2018 The Authors.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Background There is disagreement in the literature about the relationship between strokes and seasonal conditions. We sought to (1) describe seasonal patterns of stroke in the United States, aim to identify sensitive populations and inform public health measures aimed at resource and (2) determine the relationship between weather variables and stroke outcomes. Methods and Results We performed a cross‐sectional study using Get With The Guidelines‐Stroke data from 896 hospitals across the continental United States. We examined effects of season, climate region, and climate variables on stroke outcomes. We identified 457 638 patients admitted from 2011 to 2015 with ischemic stroke. There was a higher frequency of admissions in winter (116 862 in winter versus 113 689 in spring, 113 569 in summer, and 113 518 in fall; P<0.0001). Winter was associated with higher odds of in‐hospital mortality (odds ratio [OR] 1.08 relative to spring, confidence interval [CI] 1.04–1.13, P=0.0004) and lower odds of discharge home (OR 0.92, CI 0.91–0.94, P<0.0001) or independent ambulation at discharge (OR 0.96, CI 0.94–0.98, P=0.0006). These differences were attenuated after adjusting for climate region and case mix and became inconsistent after controlling for weather variables. Temperature and precipitation were independently associated with outcome after multivariable analysis, with increases in temperature and precipitation associated with lower odds of mortality (OR 0.95, CI 0.93–0.97, P<0.0001 and OR 0.95, CI 0.90–1.00, P=0.035, respectively). Conclusions Admissions for ischemic stroke were more frequent in the winter. Warmer and wetter weather conditions were independently associated with better outcomes. Further studies should allocation, readiness, and adaptive strategies.
AB - Background There is disagreement in the literature about the relationship between strokes and seasonal conditions. We sought to (1) describe seasonal patterns of stroke in the United States, aim to identify sensitive populations and inform public health measures aimed at resource and (2) determine the relationship between weather variables and stroke outcomes. Methods and Results We performed a cross‐sectional study using Get With The Guidelines‐Stroke data from 896 hospitals across the continental United States. We examined effects of season, climate region, and climate variables on stroke outcomes. We identified 457 638 patients admitted from 2011 to 2015 with ischemic stroke. There was a higher frequency of admissions in winter (116 862 in winter versus 113 689 in spring, 113 569 in summer, and 113 518 in fall; P<0.0001). Winter was associated with higher odds of in‐hospital mortality (odds ratio [OR] 1.08 relative to spring, confidence interval [CI] 1.04–1.13, P=0.0004) and lower odds of discharge home (OR 0.92, CI 0.91–0.94, P<0.0001) or independent ambulation at discharge (OR 0.96, CI 0.94–0.98, P=0.0006). These differences were attenuated after adjusting for climate region and case mix and became inconsistent after controlling for weather variables. Temperature and precipitation were independently associated with outcome after multivariable analysis, with increases in temperature and precipitation associated with lower odds of mortality (OR 0.95, CI 0.93–0.97, P<0.0001 and OR 0.95, CI 0.90–1.00, P=0.035, respectively). Conclusions Admissions for ischemic stroke were more frequent in the winter. Warmer and wetter weather conditions were independently associated with better outcomes. Further studies should allocation, readiness, and adaptive strategies.
KW - Cerebrovascular disease
KW - Environment
KW - Epidemiology
KW - Ischemic stroke
KW - Seasonal variation
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U2 - 10.1161/JAHA.118.010020
DO - 10.1161/JAHA.118.010020
M3 - Article
C2 - 30571497
AN - SCOPUS:85057102207
SN - 2047-9980
VL - 7
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 22
M1 - e010020
ER -