Abstract
Background and purposeAlthough the effect of weather and air pollution on the occurrence of subarachnoid hemorrhage (SAH) has been investigated, results have remained inconsistent. The present study aimed to determine the seasonality of aneurysmal subarachnoid hemorrhage occurrence and mortality.MethodsWe used the National Inpatient Sample database to evaluate the effect of meteorological factors and air pollutants on patients with subarachnoid hemorrhage in Korea between 2011 and 2014. Monthly variations in SAH occurrence and mortality were analyzed using locally weighted scatter plot smoothing curves. Multivariate Poisson generalized linear regression models were used to evaluate potential independent meteorological and pollutant variables associated with SAH occurrence and mortality.ResultsIn total, 21,407 patients who underwent clip or coil treatment owing to aneurysmal SAH in Korea from January 1, 2011, to December 31, 2014, were included. The crude incidence rate of SAH in Korea was 10.5 per 100,000 people per year. An approximately 0.5% lower risk of SAH was observed per 1°C increase in mean monthly temperature (relative risk, 0.995; 95% confidence interval [CI], 0.992–0.997; p < 0.001), while an approximately 2.3% higher risk of SAH was observed per 1°C increase in mean monthly diurnal temperature.ConclusionsWe showed distinct patterns of seasonal and monthly variation in the occurrence and mortality of SAH. Our findings suggest that meteorological factors may play an important role in monthly variations in the occurrence of aneurysmal SAH.
Highlights
The influence of weather and air pollution on the occurrence of aneurysmal subarachnoid hemorrhage (SAH) has been widely investigated numerous countries; their results remain inconsistent
21,407 patients who underwent clip or coil treatment owing to aneurysmal SAH in Korea from January 1, 2011, to December 31, 2014, were included
An approximately 0.5% lower risk of SAH was observed per 1 ̊C increase in mean monthly temperature, while an approximately 2.3% higher risk of SAH was observed per 1 ̊C increase in mean monthly diurnal temperature
Summary
The influence of weather and air pollution on the occurrence of aneurysmal subarachnoid hemorrhage (SAH) has been widely investigated numerous countries; their results remain inconsistent. Several researchers have reported that the incidence of SAH is lower in the summer,[1,2] additional studies have revealed no seasonal variability in the occurrence of SAH.[3,4,5,6] Various meteorological factors such as temperature, atmospheric pressure, and other weather parameters have been investigated to evaluate their possible association with SAH seasonality and mortality.[2,7,8,9,10,11,12,13] Several hypothesized mechanisms linking temperature, SAH occurrence, and mortality have been suggested. The effect of weather and air pollution on the occurrence of subarachnoid hemorrhage (SAH) has been investigated, results have remained inconsistent. The present study aimed to determine the seasonality of aneurysmal subarachnoid hemorrhage occurrence and mortality
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