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Ambient Temperature and Stroke Occurrence: A Systematic Review and Meta-Analysis.pdf (766.91 kB)

Ambient Temperature and Stroke Occurrence: A Systematic Review and Meta-Analysis.

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posted on 2016-12-02, 11:01 authored by X. Wang, Y. Cao, D. Hong, D. Zheng, S. Richtering, E. C. Sandset, T. H. Leong, H. Arima, S. Islam, A. Salam, C. Anderson, Thompson Robinson, M. L. Hackett
Biologically plausible associations exist between climatic conditions and stroke risk, but study results are inconsistent. We aimed to summarize current evidence on ambient temperature and overall stroke occurrence, and by age, sex, and variation of temperature. We performed a systematic literature search across MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and GEOBASE, from inception to 16 October 2015 to identify all population-based observational studies. Where possible, data were pooled for meta-analysis with Odds ratios (OR) and corresponding 95% confidence intervals (CI) by means of the random effects meta-analysis. We included 21 studies with a total of 476,511 patients. The data were varied as indicated by significant heterogeneity across studies for both ischemic stroke (IS) and intracerebral hemorrhage (ICH). Pooled OR (95% CI) in every 1 degree Celsius increase in ambient temperature was significant for ICH 0.97 (0.94-1.00), but not for IS 1.00 (0.99-1.01) and subarachnoid hemorrhage (SAH) 1.00 (0.98-1.01). Meta-analysis was not possible for the pre-specified subgroup analyses by age, sex, and variation of temperature. Change in temperature over the previous 24 h appeared to be more important than absolute temperature in relation to the risk of stroke, especially in relation to the risk of ICH. Older age appeared to increase vulnerability to low temperature for both IS and ICH. To conclude, this review shows that lower mean ambient temperature is significantly associated with the risk of ICH, but not with IS and SAH. Larger temperature changes were associated with higher stroke rates in the elderly.

Funding

Yongjun Cao is funded by National Natural Science Foundation of China (81471195) and 2nd Affiliated Hospital of Soochow University Preponderant Clinic Discipline Group Project Funding (XKQ2015002). Daqing Hong is funded by Youth Science and Technology Creative Research Groups of Sichuan Province (2015TD0013). Maree L. Hackett is a recipient of a National Heart Foundation Future Leader Fellowship, Level 2 (100034, 2014–2017). Thompson Robinson is an NIHR Senior Investigator.

History

Citation

International Journal of Environmental Research and Public Health, 2016, 13(7), 698

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

  • VoR (Version of Record)

Published in

International Journal of Environmental Research and Public Health

Publisher

MDPI

issn

1660-4601

eissn

1660-4601

Acceptance date

2016-07-04

Available date

2016-12-02

Publisher version

http://www.mdpi.com/1660-4601/13/7/698

Notes

The following are available online at www.mdpi.com/1660-4601/13/7/698/s1, Table S1: Meta-analysis for ambient temperature and ischemic stroke (IS), Table S2: Studies included in systematic review of mean temperature and ischemic stroke (IS), Table S3: Studies included in systematic review of mean temperature and ischemic stroke (IS) by sex, Table S4: Studies included in systematic review of ambient temperature and ischemic stroke (IS) by age, Table S5: Studies included in systematic review of temperature change and ischemic stroke (IS), Table S6: Meta analysis for mean temperature and intracerebral hemorrhage (ICH), Table S7: Studies only included in systematic review of mean temperature and intracerebral hemorrhage (ICH), Table S8: Studies included in systematic review of mean temperature and intracerebral hemorrhage (ICH) by sex, Table S9: Studies included in systematic review of ambient temperature and intracerebral hemorrhage (ICH) by age, Table S10: Studies included in systematic review of temperature change and intracerebral hemorrhage (ICH), Table S11: studies for mean temperature and subarachnoid hemorrhage (SAH), Table S12: Studies included in systematic review of ambient temperature and subarachnoid hemorrhage (SAH).

Language

en

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