Seasonal incidence of ruptured abdominal aortic aneurysm and the influence of atmospheric pressure: a systematic review and meta-analysis

Abstract

Ruptured abdominal aortic aneurysm (rAAA) is a life-threatening condition with a high mortality rate. Seasonal variations in the incidence of rAAA and the influence of atmospheric pressure have been studied throughout decades; however, the conclusions are contradictory. Therefore, we aimed to conduct a meta-analysis and systematic review of literature on seasonal variations in rAAA incidence and the influence of atmospheric pressure. Studies investigating seasonal variations in rAAA incidence and influence of atmospheric pressure were retrieved. For dichotomous data, we generated risk ratios (RRs) and 95% confidence intervals (CIs) for rAAA incidence compared among seasons. The studies were subdivided according to latitude, elevation, and climatic types, for subgroup comparisons. Studies reporting monthly incidence and seasonal mortality were further investigated. For continuous data, standardized mean differences (SMDs) and 95% CIs were generated for atmospheric pressure comparisons. Twenty-four eligible studies were included, comprising a total of 38,506 patients with rAAA. Pooled rAAA incidence was 25% in spring, 23% in summer, 26% in autumn, and 26% in winter. Pooled analysis demonstrated a statistically significant higher rAAA incidence in winter than in summer (RR 1.10, P = 0.04) and in autumn than in summer (RR 1.11, P < 0.00001). However, there was no statistically significant difference among other seasons. In the study of the influence of atmospheric pressure, no statistically significant difference was observed. In conclusion, our study revealed a higher incidence of rAAA in autumn and winter than in summer; however, atmospheric pressure was found to exert no influence.

The Effects of Changing Meteorological Parameters on Fatal Aortic Catastrophes

“…The connections between meteorological parameters and acute aortic catastrophes have also been studied previously [10][11][12][13]22 . Early studies focused primarily on seasonal and monthly changes in mortality rate 10,11,14,23,24 .…”

“…When we compare this to others, Liapis at al from Greece observed an autumnal peak, Ballaro and Bown from the UK found a winter peak, as did Upshur et al from Canada, while Majd et al from Germany also reported an autumnal peak. According to a meta-analysis and systematic review on rAA topic, seasonal variation exists with higher incidence in autumn and winter 13 . Takagi et al after meta-analysis and systematic review concluded that AAD also have seasonal variation with winter peak 25 .…”

“…The increased mortality rate for cardio-and cerebrovascular patients under extreme weather conditions (extreme cold and heat) is also known 8,9 . Several articles have been published on this subject, although many controversies exist as to whether a correlation is present [10][11][12][13][14][15][16] . We think the controversy stems from the differences in local meteorological conditions, observed parameters, and methodologies, the combination of which leads to different conclusions.…”

“…Several studies discuss the connection between cardiovascular diseases (pulmonary embolism, ruptured aortic aneurysm, acute coronary syndrome, aortic dissection) and changes in meteorological parameters 10,17,18 . Several articles examine the effects of weather on aneurysms and dissections [10][11][12][13][14][15][16] . All of these strive to prove a connection between the given medical condition and the meteorological parameter or its changes.…”

The Effects of Changing Meteorological Parameters on Fatal Aortic Catastrophes

“…The increased mortality rate for cardio-and cerebrovascular patients under extreme weather conditions (extreme cold and heat) is also known 8,9 . Several articles have been published on this subject, although many controversies exist as to whether a correlation is present [10][11][12][13][14][15][16] . We think the controversy stems from the differences in local meteorological conditions, observed parameters, and methodologies, the combination of which leads to different conclusions.…”