The Association between Meteorological Factors and the Prevalence of Acute-on-chronic Liver Failure: A Population-based Study, 2007–2016

Abstract

Background and Aims: The aim of this study was to investigate the effect(s) of meteorological factors on the prevalence of acute-on-chronic liver failure (ACLF) based on 10-years' worth of population data. Methods: We retrospectively collected ACLF case data from January 2007 to December 2016 from three major hospitals in Fuzhou City, China. Climatic data, including rainfall, mean temperature, differences in temperature (delta temperature) and mean humidity for each month were downloaded from the China Climatic Data Service Center. Following data collection, Poisson regression analysis was used to estimate the effect(s) of climatic factors on the risk of the prevalence of ACLF. Results: The population consisted of a total of 3510 cases, with a mean age of 44.7 ± 14.8 years-old and with 79.8% being male. Upon analyzing the population data, we found a growing trend and seasonal pattern of monthly counts of ACLF-related hospitalization throughout the past decade. Specifically, the primary peak of ACLF prevalence was in January and the secondary peak was in July. Poisson regression showed mean temperature (risk ratio = 0.991, 95%CI = 0.986-0.996) and mean humidity (risk ratio = 1.011, 95%CI = 1.006-1.017) to be independently correlated with the monthly cases of ACLF. The results suggest that every unit increase of mean temperature (1°C) and mean humidity (1%) are associated with 0.991-and 1.011-fold changes of ACLF cases, respectively. Rainfall and delta temperature did not appear to affect the prevalence of this disease. Conclusions: The hospitalization for ACLF peaks in January and July. Low temperature and high humidity appear to function as factors contributing to this seasonal pattern.

Can Weather Influence the Prevalence of Acute-on-chronic Liver Failure?

“…5 Rainfall and change of temperature did not affect the incidence of ACLF. 5 The authors conclude that low temperature and high humidity contribute to the seasonal pattern of ACLF observed in their patient population. This supports that meteorological factors could have an influence on ACLF.…”

“…In the current issue, Lin et al describe that meteorological patterns can have an influence on the prevalence of ACLF, which has previously not been investigated. 5 In the 3,510 cases that the authors studied from three hospitals in Fuzhou City, China, there was a positive correlation of average humidity and a negative correlation of temperature with the prevalence of ACLF. 5 In addition, the highest prevalence of ACLF was observed in January, followed by July.…”

“…5 In the 3,510 cases that the authors studied from three hospitals in Fuzhou City, China, there was a positive correlation of average humidity and a negative correlation of temperature with the prevalence of ACLF. 5 In addition, the highest prevalence of ACLF was observed in January, followed by July. 5 Rainfall and change of temperature did not affect the incidence of ACLF.…”

“…5 In addition, the highest prevalence of ACLF was observed in January, followed by July. 5 Rainfall and change of temperature did not affect the incidence of ACLF. 5 The authors conclude that low temperature and high humidity contribute to the seasonal pattern of ACLF observed in their patient population.…”

“…8 Therefore, as the study by Lin et al found that lower temperatures were associated with increased prevalence of ACLF, it was likely not due to any direct effect of hyperthermia or hypothermia. 5 While the influence of seasonal meteorological factors on liver diseases is an area that has not been extensively studied, there is some evidence of seasonality towards the viral hepatitis infections of hepatitis A, B, C, and E as they are more prominent in the spring and summer. 9 In addition, studies outside the liver have shown bacterial infections can be influenced by weather as gastroenteritis hospitalizations in Spain were studied and both hot and cold temperatures increased risk, while precipitation reduced the incidence of hospitalization.…”