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Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States.

Publication ,  Journal Article
Chu, SY; Cox, M; Fonarow, GC; Smith, EE; Schwamm, L; Bhatt, DL; Matsouaka, RA; Xian, Y; Sheth, KN
Published in: J Am Heart Assoc
November 20, 2018

Background There is disagreement in the literature about the relationship between strokes and seasonal conditions. We sought to (1) describe seasonal patterns of stroke in the United States, and (2) determine the relationship between weather variables and stroke outcomes. Methods and Results We performed a cross-sectional study using Get With The Guidelines-Stroke data from 896 hospitals across the continental United States. We examined effects of season, climate region, and climate variables on stroke outcomes. We identified 457 638 patients admitted from 2011 to 2015 with ischemic stroke. There was a higher frequency of admissions in winter (116 862 in winter versus 113 689 in spring, 113 569 in summer, and 113 518 in fall; P<0.0001). Winter was associated with higher odds of in-hospital mortality (odds ratio [OR] 1.08 relative to spring, confidence interval [ CI ] 1.04-1.13, P=0.0004) and lower odds of discharge home ( OR 0.92, CI 0.91-0.94, P<0.0001) or independent ambulation at discharge ( OR 0.96, CI 0.94-0.98, P=0.0006). These differences were attenuated after adjusting for climate region and case mix and became inconsistent after controlling for weather variables. Temperature and precipitation were independently associated with outcome after multivariable analysis, with increases in temperature and precipitation associated with lower odds of mortality ( OR 0.95, CI 0.93-0.97, P<0.0001 and OR 0.95, CI 0.90-1.00, P=0.035, respectively). Conclusions Admissions for ischemic stroke were more frequent in the winter. Warmer and wetter weather conditions were independently associated with better outcomes. Further studies should aim to identify sensitive populations and inform public health measures aimed at resource allocation, readiness, and adaptive strategies.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 20, 2018

Volume

7

Issue

22

Start / End Page

e010020

Location

England

Related Subject Headings

  • United States
  • Temperature
  • Stroke
  • Seasons
  • Risk Factors
  • Rain
  • Odds Ratio
  • Multivariate Analysis
  • Male
  • Humans
 

Citation

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Chu, S. Y., Cox, M., Fonarow, G. C., Smith, E. E., Schwamm, L., Bhatt, D. L., … Sheth, K. N. (2018). Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States. J Am Heart Assoc, 7(22), e010020. https://doi.org/10.1161/JAHA.118.010020
Chu, Stacy Y., Margueritte Cox, Gregg C. Fonarow, Eric E. Smith, Lee Schwamm, Deepak L. Bhatt, Roland A. Matsouaka, Ying Xian, and Kevin N. Sheth. “Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States.J Am Heart Assoc 7, no. 22 (November 20, 2018): e010020. https://doi.org/10.1161/JAHA.118.010020.
Chu SY, Cox M, Fonarow GC, Smith EE, Schwamm L, Bhatt DL, et al. Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States. J Am Heart Assoc. 2018 Nov 20;7(22):e010020.
Chu, Stacy Y., et al. “Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States.J Am Heart Assoc, vol. 7, no. 22, Nov. 2018, p. e010020. Pubmed, doi:10.1161/JAHA.118.010020.
Chu SY, Cox M, Fonarow GC, Smith EE, Schwamm L, Bhatt DL, Matsouaka RA, Xian Y, Sheth KN. Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States. J Am Heart Assoc. 2018 Nov 20;7(22):e010020.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 20, 2018

Volume

7

Issue

22

Start / End Page

e010020

Location

England

Related Subject Headings

  • United States
  • Temperature
  • Stroke
  • Seasons
  • Risk Factors
  • Rain
  • Odds Ratio
  • Multivariate Analysis
  • Male
  • Humans