Abstract
Background: Stroke is a medical condition that leads to major disability and mortality worldwide. Some evidence suggests that weather and seasonal variations could have an impact on stroke incidence and outcome. However, the current evidence is inconclusive. Therefore, this study examines the seasonal variations and meteorological influences on stroke incidence and outcome in the largest city in Saudi Arabia.Methods: From February 2016 to July 2019, we retrospectively reviewed data from all patients with acute ischemic (AIS) or hemorrhagic stroke (HS) admitted to the stroke unit in a tertiary academic center in Saudi Arabia. The corresponding daily meteorological data were obtained for the same period. We considered the months from November to March as the cold season and April to October as the hot season.Results: The final cohort included 1,271 stroke patients; 60.89% (n = 774) cases occurred in the hot season, while 39.1% (n = 497) in the cold season. Males accounted for 69.6% (n = 884) of the cases. The proportion of ischemic stroke was 83.2% [hot season 83.9% (n = 649) vs. cold season 82.3% (n = 409)]. We found no statistically significant difference between seasons (hot or cold) in stroke incidence, severity [National Institutes of Health Stroke Scale (NIHSS)], hospital course (pneumonia, thromboembolism, intensive care stay, or length of stay), or outcome [modified Rankin scale (mRS) on discharge and death].Conclusions: In Riyadh, Saudi Arabia, our study found no impact of weather or seasonal variations on stroke incidence, hospital course, or outcomes. However, our findings warrant further research in different country regions.
Highlights
Stroke accounts for over 13 million cases and 5.5 million deaths annually [1]
We investigate if atmospheric pressure, wind speed, and relative humidity in the hot and cold seasons impact stroke incidence
We reviewed all electronic medical records for patients who fit the inclusion criteria for the following variables: date of admission, demographic data, vascular risk factors, treatment with reperfusion therapy [tissue plasminogen activator] or endovascular treatment (EVT), modified Rankin scale on admission, National Institutes of Health Stroke Scale (NIHSS) on admission and discharge, length of stay (LOS), and inhospital complications and death
Summary
Stroke accounts for over 13 million cases and 5.5 million deaths annually [1]. The overall age-standardized stroke incidence rates, deaths, disability-adjusted life years (DALYs) have decreased [1]. Absolute stroke numbers are increasing significantly in developing countries, like the Kingdom of Saudi Arabia (KSA) [1, 2]. In KSA, stroke is highly prevalent, with an estimated 26,000 cases in 2016 [1]. An epidemiological model predicted an increase of 67% in the first stroke in the upcoming 10 years [3]. Some evidence suggests that weather and seasonal variations could have an impact on stroke incidence and outcome.
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