Abstract
Background and Purpose: The relationship between stroke and short-term temperature changes remains controversial. Therefore, we conducted a systematic review and meta-analysis to investigate the association between stroke and both high and low temperatures, and health assessment. Methods: We searched PubMed, Embase, Cochrane, China National Knowledge Infrastructure (CNKI) and Wanfang Data up to 14 September 2014. Study selection, quality assessment, and author-contractions were steps before data extraction. We converted all estimates effects into relative risk (RR) per 1 °C increase/decrease in temperature from 75th to 99th or 25th to 1st percentiles, then conducted meta-analyses to combine the ultimate RRs, and assessed health impact among the population. Results: 20 articles were included in the final analysis. The overall analysis showed a positive relationship between 1 °C change and the occurrence of major adverse cerebrovascular events (MACBE), 1.1% (95% confidence intervals (CI), 0.6 to 1.7) and 1.2% (95% CI, 0.8 to 1.6) increase for hot and cold effects separately. The same trends can be found in both effects of mortality and the cold effect for morbidity. Hot temperature acted as a protective factor of hemorrhage stroke (HS), −1.9% (95% CI, −2.8 to −0.9), however, it acted as a risk factor for ischemic stroke (IS), 1.2% (95% CI, 0.7 to 1.8). Conclusion: Short-term changes of both low and high temperature had statistically significant impacts on MACBE.
Highlights
The relationship between global climate changes and their effects on human health have been taken into the hub of public attention [1,2]
Of the remaining 43 articles, 11 were deleted for not providing the full text of the articles, two provided estimate effects based on temperature range [18,19], four showed interests in cardiovascular diseases, while stroke did not appear as a subgroup [20,21,22,23], three only found a positive relationship (p < 0.05) without an relative risk (RR)/odds ratio (OR) [24,25,26], one focused on the daily temperature range [27]
No obvious publication bias was found after testing, except the combined effect for major adverse cerebrovascular events (MACBE) in the cold days
Summary
The relationship between global climate changes and their effects on human health have been taken into the hub of public attention [1,2]. We conducted a systematic meta-analysis to investigate the association between temperature and the risk of stroke. We conducted a systematic review and meta-analysis to investigate the association between stroke and both high and low temperatures, and health assessment. We converted all estimates effects into relative risk (RR) per 1 °C increase/decrease in temperature from 75th to 99th or 25th to 1st percentiles, conducted meta-analyses to combine the ultimate RRs, and assessed health impact among the population. The overall analysis showed a positive relationship between 1 °C change and the occurrence of major adverse cerebrovascular events (MACBE), 1.1% (95% confidence intervals (CI), 0.6 to 1.7) and
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