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Abstract
BackgroundStroke is a major health problem around the world. Several studies have examine the influence of ambient temperature on incidence of stoke, but they reported different results for different types of stroke and different geographical regions. Hence, effect of ambient temperature is still much of interest, when focusing on ischemic stroke (IS) in regions that have not been examined yet. The aim of our study is to analyse association between IS incidences and short, delayed and cumulative effect of average daily ambient temperature, humidity and pressure in central Europe. To the best of our knowledge, this is the first IS study conducted between 45° and 50° latitude where large part of Central European population resides.MethodsWe linked daily hospitals’ admission data for whole population and separately for two specific age groups with ambient temperature data. We considered patients coming from Ljubljana basin and its immediate surrounding. Data were gathered daily from January 2012 to December 2017. To measure the effect of average ambient temperature, humidity and pressure we used generalized linear model with a log-link-function and a Poisson distribution.ResultsThe results of our study show a statistically significant immediate, delayed and cumulative effects of ambient temperatures on IS incidence for the whole population and the population older than 65 years. Specifically, 1 °C reduction in ambient temperature on a given day (Lag 0) increases the IS risk for approximately 5‰ (all population) or 6‰ (population older than 65 years). Similar effects were found for lags from 1 to 6. Analysis of time windows from 0 to 1 days up to 0–28 days also show statistically significant cumulative effect for the same two age groups. IS incidence was not found to be significantly related to pressure or humidity in any group.ConclusionThe findings of this study may help healthcare authorities in central Europe improve existing stroke prevention measures and raise public awareness.
Highlights
Stroke is a major health problem around the world
A recent meta-analysis [2] provides evidence that the geographic latitude is the most significant source of this inconsistency. Their metaanalysis shows a lack of ischaemic stroke (IS) studies on population living in a belt between 45°N and 50°N latitude
We can assume that 1 °C reduction in ambient temperature on a given day (Lag 0) increases the ischemic stroke (IS) incidence for approximately 5‰ for all population, while for population older than 65 years it increases the IS incidence for approximately 6‰
Summary
Several studies have examine the influence of ambient temperature on incidence of stoke, but they reported different results for different types of stroke and different geographical regions. To the best of our knowledge, this is the first IS study conducted between 45° and 50° latitude where large part of Central European population resides. It has been known for many decades that low and/or high ambient temperature influences the risk of morbidity and mortality worldwide. A recent meta-analysis [2] provides evidence that the geographic latitude is the most significant source of this inconsistency Their metaanalysis shows a lack of ischaemic stroke (IS) studies on population living in a belt between 45°N and 50°N latitude. This belt is of special interest for Central Europe as many capitals and large cities like Bratislava, Budapest, Munich, Stuttgart, Vienna, and Zurich etc. are located here
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