Association of Ambient Particulate Matter Pollution of Different Sizes With In-Hospital Case Fatality Among Stroke Patients in China

作者：Miao Cai, Shiyu Zhang, Xiaojun Lin, Zhengmin Qian, Stephen Edward McMillin, Yin Yang, Zilong Zhang, Jay Pan, Hualiang Lin · 发表于：Neurology · 年份：2022 · DOI：10.1212/wnl.0000000000200546 · 被引用次数：62 · 研究领域：Air Quality and Health Impacts、Air Quality Monitoring and Forecasting、COVID-19 and healthcare impacts

Background and Objectives To characterize the association of ambient particulate matter (PM) pollution of different sizes (PM ≤1 µm in aerodynamic diameter [PM 1 ], PM 2.5 , and PM 10 ) with in-hospital case fatality among patients with stroke in China. Methods We collected hospitalizations due to stroke in 4 provinces in China from 2013 to 2019. Seven-day and annual averages of PM prior to hospitalization were estimated using bilinear interpolation and residential addresses. Associations with in-hospital case fatality were estimated using random-effects logistic regression models. Potential reducible fraction and the number of fatalities attributed to PM were estimated using a counterfactual approach. Results Among 3,109,634 stroke hospitalizations (mean age 67.23 years [SD 12.22]; 1,765,644 [56.78%] male), we identified 32,140 in-hospital stroke fatalities (case fatality rate 1.03%). Each 10 µg/m 3 increase in 7-day average (short-term) exposure to PM was associated with increased in-hospital case fatality: odds ratios (ORs) were 1.058 (95% CI 1.047–1.068) for PM 1 , 1.037 (95% CI 1.031–1.043) for PM 2.5 , and 1.025 (95% CI 1.021–1.029) for PM 10 . Similar but larger ORs were observed for annual averages (long-term): 1.240 (95% CI 1.217–1.265) for PM 1 , 1.105 (95% CI 1.094–1.116) for PM 2.5 , and 1.090 (95% CI 1.082–1.099) for PM 10 . In counterfactual analyses, PM 10 was associated with the largest potential reducible fraction in in-hospital case fatality (10% [95%...