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首页> 外文期刊>Environmental research >Associations of extreme temperatures with hospitalizations and post-discharge deaths for stroke: What is the role of pre-existing hyperlipidemia?
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Associations of extreme temperatures with hospitalizations and post-discharge deaths for stroke: What is the role of pre-existing hyperlipidemia?

机译：极端温度与住院治疗和排放后死亡的关联：预先存在的高脂血症是什么？

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Background: Existing evidence has suggested that heat exposure was associated with increase of low-density lipoprotein (LDL) and decrease of high-density lipo-protein (HDL). This study aimed to assess the effects of extreme temperatures (i.e., heat and cold) on hospitalizations and post-discharge deaths for stroke amongst individuals with and without pre-existing hyperlipidemia, and examine whether individual- and community-level characteristics modified the temperature-stroke relationship. Methods: People who were hospitalized for stroke from 1st January 2005 to 31st December 2013 in Brisbane, Australia, and died from stroke within two months after discharge were included in this cohort study. The effects of extreme temperatures on hospitalizations and post-discharge deaths for stroke in patients with and without pre-existing hyperlipidemia were quantified using a time-stratified case-crossover design with conditional logistic regression. Suburb-level temperature data were used to minimize exposure measurement bias. Relative humidity, NO_2 and PM_(10) were adjusted as potential confounders in the regression. Subgroup analyses were conducted to examine if age, sex, and suburb-level greenspace (measured as normalized difference vegetation index (NDVI)) and socioeconomic status (measured as Socio-Economic Indexes for Areas (SEIFA)) modified the temperature-stroke relationship in the hyperlipidemia group and the non-hyperlipidemia group. Results: There were 11,469 hospitalizations for stroke during the study period, and 2270 (19.79%) of them died within two months after discharge. Significant effect of heat on hospitalizations for stroke was observed only in individuals with pre-existing hyperlipidemia (odds ratio (OR): 1.85; 95% confidence interval (CI): 1.07-3.19), and significant effect of cold on hospitalizations was found in individuals without pre-existing hyperlipidemia (OR: 1.60; 95% CI: 1.03-2.47). Males appeared to be more vulnerable to the effects of heat and cold on hospitalizations for stroke than females. People living in suburbs with low-level greenspace (OR: 4.23; 95% CI: 1.08-16.61) were more vulnerable to heat effect on stroke hospitalizations than those living in suburbs with high-level greenspace (OR: 1.41; 95% CI: 0.32-6.16). People living in suburbs with the lowest socioeconomic advantage level or the lowest economic resources level were most vulnerable the effects of heat and cold on hospitalizations for stroke. No significant effect of heat or cold on post-discharge deaths from stroke was observed. Conclusions: This study provides suggestive evidence that heat adaptation strategies aiming to reduce stroke attacks may need to target those individuals with preexisting hyperlipidemia.
机译：背景：现有证据表明，热暴露与低密度脂蛋白（LDL）的增加有关，以及高密度脂蛋白（HDL）的降低。本研究旨在评估极端温度（即热和冷）对住院治疗和卒中后病毒后死亡的影响，无论有预先存在的高脂血症，并检查个人和社区水平特征是否改变了温度 - 冲程关系。方法：从2005年1月1日到2013年1月1日至2013年12月31日入院的人，在澳大利亚Brisbane，并在院制的两个月内与中风中纳入其中的裁员。使用具有条件逻辑回归的时间分层壳体交叉设计量化具有和不含预先存在的高脂血症的患者的住院治疗和出院后死亡的影响。使用郊区温度数据来最小化曝光测量偏压。相对湿度，NO_2和PM_（10）被调整为回归中的潜在混淆。进行亚组分析，以检查年龄，性别和郊区的绿色空间（测量为归一化差异植被指数（NDVI））和社会经济地位（作为区域的社会经济指标（SEIFA））修改了温度 - 中风关系高脂血症组和非高脂血症组。结果：研究期间有11,469份入院，其中2270名（19.79％）在出院后的两个月内死亡。仅在具有预先存在的高脂血症的个体中观察到中风住院的显着影响（赔率比（或）：1.85; 95％; 95％置信区间（CI）：1.07-3.19），发现了对住院治疗的显着影响没有预先存在的高脂血症的个体（或：1.60; 95％CI：1.03-2.47）。雄性似乎更容易受到热量和寒冷的影响，而不是卒中的住院，而不是女性。生活在郊区的郊区的人们（或：4.23; 95％CI：1.08-16.61）比患有高水平的GREENSPACE郊区的人（或：1.41; 95％CI： 0.32-6.16）。生活在郊区的社会经济优势水平或最低的经济资源水平最脆弱的人最容易受到热量和寒冷的脑卒中住院的影响。观察到从中风后排出后死亡的热量或寒冷没有显着影响。结论：本研究提供了暗示旨在减少中风攻击的热适应策略可能需要针对具有预先存在的高脂血症的人。

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  • 来源
    《Environmental research》 |2021年第2期|110391.1-110391.5|共5页
  • 作者

    Zhiwei Xu; Shilu Tong; Haifeng Pan; Jian Cheng;

  • 作者单位

    School of Public Health Faculty of Medicine University of Queensland Brisbane Australia;

    Department of Clinical Epidemiology and Biostatistics Shanghai Children s Medical Center Shanghai Jiaotong University School of Medicine Shanghai China School of Public Health Nanjing Medical University Nanjing China School of Public Health Anhui Medical University Hefei China School of Public Health and Social Work & Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia;

    School of Public Health Anhui Medical University Hefei China;

    School of Public Health Anhui Medical University Hefei China School of Public Health and Social Work & Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia;

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