Various meteorological conditions exhibit both immediate and delayed influences on the risk of stroke events: The HEWS–stroke study

Abstract

We hypothesized that meteorological conditions on the onset day and conditions on the former days may play important roles in the modulation of physical conditions. Associations of meteorological factors and their changes in former days with stroke onset are of interest. We conducted a multicenter retrospective study to evaluate the frequency of stroke events and their interaction with meteorological conditions and their daily changes. Acute stroke patients (n = 3935, 73.5±12.4 years, 1610 females) who were admitted to 7 stroke hospitals in three restricted areas were enrolled in this study. Poisson regression models involving time-lag variables was used to compare daily rates of stroke events with mean thermo-hydrological index (THI), atmospheric pressure, and their daily changes. We divided onset days into quintiles based on the THI, atmospheric pressure, and their daily changes for the last 7 days. The frequencies of ischemic stroke significantly increased when THI varied either cooler or warmer from a previous day (extremely cooler, risk ratio (RR) 1.19, 95% confidence interval (CI) 1.05 to 1.34; extremely warmer, RR 1.16, 95% CI 1.03 to 1.31; r2 = 0.001 for the best regression, p = 0.001). Intracerebral hemorrhage frequencies significantly decreased on high-THI days (extremely high, RR 0.72, 95% CI 0.54 to 0.95; r2 = 0.013 for the best regression, p<0.001) and increased in high atmospheric pressure days (high, RR 1.31, 95% CI 1.04 to 1.65; r2 = 0.009 for the best regression, p<0.001). Additionally, even after adjusting for the THI on the onset day and its changes for the other days, intracerebral hemorrhage increased when THI got extremely cooler in 4 days prior (RR 1.33, 95% CI 1.03 to 1.71, r2 = 0.006 for the best regression, p<0.001). Various meteorological conditions may exhibit influences on stroke onset. And, when temperature cooled, there may be a possibility to show delayed influence on the frequency of intracerebral hemorrhage 4 days later.

Association between stroke occurrence and changes in atmospheric circulation

“…Air temperature (T) and atmospheric pressure (AP) are among the most closely studied weather variables; increases, decreases, and fluctuations in both have been significantly linked to numerous stroke subtypes. A statistically significant negative association has been observed between T and the incidence of ischaemic stroke (IS) [ 6 – 8 ], haemorrhagic stroke (HS) [ 9 , 10 ], intracerebral haemorrhage [ 11 – 14 ]], and subarachnoid haemorrhage [ 15 – 17 ]. The results of a meta-analysis [ 4 ] have also shown a negative association between daily T and all stroke subtypes.…”

“…Studies have shown both a negative association [ 1 , 12 , 18 ] and a positive association [ 14 , 15 , 19 ] between the risk of stroke and AP. Studies conducted predominantly in Europe have shown an increase in the incidence of stroke associated with AP changes, adjusting for T or seasonality [ 19 – 22 ].…”

Preliminary development of a prediction model for daily stroke occurrences based on meteorological and calendar information using deep learning framework (Prediction One; Sony Network Communications Inc., Japan)

“…[ 16 ] In addition, ICH increases when the thermohydrological index (THI) gets extremely cooler in 4 days prior. [ 14 ]…”

Association Between Stroke Occurrence And Changes In Atmospheric Circulation&nbsp;

“…Air temperature (T) and atmospheric pressure (AP) are among the most closely studied weather variables; increases, decreases, and uctuations in both have been signi cantly linked to numerous stroke subtypes. A statistically signi cant negative association has been observed between T and the incidence of ischaemic stroke (IS) [6][7][8], haemorrhagic stroke (HS) [9,10], intracerebral haemorrhage [11][12][13][14] ], and subarachnoid haemorrhage [15][16][17]. The results of a meta-analysis [4] have also shown a negative association between daily T and all stroke subtypes.…”

“…Studies have shown both a negative association [1,12,18] and a positive association [14,15,19] between the risk of stroke and AP. Studies conducted predominantly in Europe have shown an increase in the incidence of stroke associated with AP changes, adjusting for T or seasonality [19][20][21][22].…”