Background
Studies assessing the relationship between meteorological factors and stroke incidence
are inconsistent. We assessed the associations of average temperature and diurnal
temperature fluctuations with ischemic stroke hospitalizations in a nationally representative
sample of patients in the United States.
Methods
Hospitalizations were identified for adults aged 18 years or older in the 2009-2011
Nationwide Inpatient Sample and linked with county-level monthly average temperatures
from the United States National Climatic Data Center. Logistic regression models assessed
the relationships of 5°F increases in average temperature and diurnal temperature
variation (difference between high- and low-daily temperatures) with the odds of ischemic
stroke hospitalization (International Classification of Diseases, Ninth Revision, Clinical Modification codes 433, 434, and 436), adjusting for patient characteristics and dew point. Models
were stratified by age (18-64, ≥65 years), season, and region, with analysis at the
hospitalization level.
Results
Increased average temperature was associated with decreased odds of stroke hospitalization
among both age groups and across seasons in the Northeast, and among the elderly in
the West. Increased diurnal temperature variation was associated with increased odds
of stroke hospitalization for nearly all regions in the spring to fall seasons; associations
were most pronounced in the Northeast and strongest in the spring.
Conclusions
Lower average temperature and larger diurnal temperature variations were associated
with stroke hospitalizations. Associations were strongest in the Northeast and largely
similar across seasons and age. Further research is needed to explore the mechanisms
underlying these associations. Understanding these patterns may lead to targeted prevention
strategies for vulnerable populations during periods of extreme weather conditions.
Key Words
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Article info
Publication history
Published online: March 30, 2016
Accepted:
February 26,
2016
Received in revised form:
February 24,
2016
Received:
January 25,
2016
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.037
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
