Low temperature and temperature decline increase acute aortic dissection risk and burden: A nationwide case crossover analysis at hourly level among 40,270 patients

作者：Qingli Zhang, Peng Li, Jialu Hu, Huichu Li, Yixuan Jiang, Weiyi Fang, Hongbing Yan, Jiyan Chen, Weimin Wang, Dingcheng Xiang, Xi Su, Bo Yu, Yan Wang, Yawei Xu, Lefeng Wang, Chunjie Li, Yundai Chen, Dong Zhao, Wenzhen Ge, Michelle L. Bell, Antonio Gasparrini, Junbo Ge, Yong Huo, Haidong Kan · 发表于：The Lancet Regional Health - Western Pacific · 年份：2022 · DOI：10.1016/j.lanwpc.2022.100562 · 被引用次数：28 · 研究领域：Climate Change and Health Impacts、Aortic Disease and Treatment Approaches、Aortic aneurysm repair treatments

Background: Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency with high mortality, so identifying modifiable risk factors of AAD is of great public health significance. The associations of non-optimal temperature and temperature variability with AAD onset and the disease burden have not been fully understood. Methods: We conducted a time-stratified case-crossover study using a nationwide registry dataset from 1,868 hospitals in 313 Chinese cities. Conditional logistic regression and distributed lag models were used to investigate associations of temperature and temperature changes between neighboring days (TCN) with the hourly AAD onset and calculate the attributable fractions. We also evaluated the heterogeneity of the associations. Findings: A total of 40,270 eligible AAD cases were included. The exposure-response curves for temperature and TCN with AAD onset risk were both inverse and approximately linear. The risks were present on the concurrent hour (for temperature) or day (for TCN) and lasted for almost 1 day. The cumulative relative risks of AAD were 1.027 and 1.026 per 1°C lower temperature and temperature decline between neighboring days, respectively. The associations were significant during the non-heating period, but were not present during the heating period in cities with central heating. 23.13% of AAD cases nationwide were attributable to low temperature and 1.58% were attributable to temperature decline from the previous day. Interp...