J Clin Neurol.  2016 Oct;12(4):476-481. 10.3988/jcn.2016.12.4.476.

Numbers of Stroke Patients and Stroke Subtypes According to Highest and Lowest Daily Temperatures in Seoul

Affiliations
  • 1Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Korea. kblee@schmc.ac.kr
  • 2Department of Neurosurgery, Soonchunhyang University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE
There is conflicting evidence for whether or not the incidence of stroke is influenced by the daily temperature. The association between daily temperature and incidence of stroke is largely unknown in Korea. This study attempted to evaluate whether the maximum or minimum daily temperature is associated with increased numbers of strokes and stroke subtypes among Seoul residents.
METHODS
We obtained the maximum and minimum daily temperatures in Seoul from the Korean Meteorological Administration between January 2005 and December 2014. Consecutive patients with acute stroke were registered who visited the emergency room or outpatient clinic in Soonchunhyang University Hospital, Seoul. The residential addresses of cases were restricted to within a 2-kilometer radius of this hospital. The stroke events were prospectively recorded with onset time, and were classified by subtypes. The categories of daily temperature were divided by 10℃ from the mean temperature. The mean daily number of strokes was calculated during the study period. One-way analysis of variance and Duncan's post-hoc test were applied to compare the number of strokes among the temperature groups.
RESULTS
In total, 2,313 acute strokes were identified during the period: 1,643 ischemic strokes and 670 hemorrhagic strokes. The number of cases was significantly higher when the maximum daily temperature was >32℃ or ≤3℃ (p=0.048) or the minimum daily temperature was ≤-11.0℃ (p=0.020). The lowest maximum daily temperature was associated with increased instances of intracerebral hemorrhage (p=0.029) and small-vessel occlusion (p=0.013), while the highest maximum daily temperature was associated with an increased instance of large-artery atherosclerosis (p=0.045).
CONCLUSIONS
The daily temperature had measurable and different associations with the number of strokes and strokes subtypes in Seoul, Korea.

Keyword

acute stroke; daily temperature; stroke incidence; stroke subtype

MeSH Terms

Ambulatory Care Facilities
Atherosclerosis
Cerebral Hemorrhage
Emergency Service, Hospital
Humans
Incidence
Korea
Prospective Studies
Radius
Seoul*
Stroke*

Reference

1. Kim JS. Stroke becomes the 3rd important cause of death in Korea; is it a time to toast? J Stroke. 2014; 16:55–56.
Article
2. Douglas AS, Russell D, Allan TM. Seasonal, regional and secular variations of cardiovascular and cerebrovascular mortality in New Zealand. Aust N Z J Med. 1990; 20:669–676.
Article
3. Jimenez-Conde J, Ois A, Gomis M, Rodriguez-Campello A, Cuadrado-Godia E, Subirana I, et al. Weather as a trigger of stroke. Daily meteorological factors and incidence of stroke subtypes. Cerebrovasc Dis. 2008; 26:348–354.
4. Miah AH, Sutradhar SR, Ahmed S, Bhattacharjee M, Alam MK, Bari MA, et al. Seasonal variation in types of stroke and its common risk factors. Mymensingh Med J. 2012; 21:13–20.
5. Ricci S, Celani MG, Vitali R, La Rosa F, Righetti E, Duca E. Diurnal and seasonal variations in the occurrence of stroke: a community-based study. Neuroepidemiology. 1992; 11:59–64.
Article
6. Wang Y, Levi CR, Attia JR, D'Este CA, Spratt N, Fisher J. Seasonal variation in stroke in the Hunter Region, Australia: a 5-year hospital-based study, 1995-2000. Stroke. 2003; 34:1144–1150.
Article
7. Field TS, Hill MD. Weather, Chinook, and stroke occurrence. Stroke. 2002; 33:1751–1757.
Article
8. Rothwell PM, Wroe SJ, Slattery J, Warlow CP. Is stroke incidence related to season or temperature? The Oxfordshire Community Stroke Project. Lancet. 1996; 347:934–936.
9. Han MH, Yi HJ, Kim YS, Kim YS. Effect of seasonal and monthly variation in weather and air pollution factors on stroke incidence in Seoul, Korea. Stroke. 2015; 46:927–935.
Article
10. Ko Y, Lee S, Chung JW, Han MK, Park JM, Kang K, et al. MRI-based algorithm for acute ischemic stroke subtype classification. J Stroke. 2014; 16:161–172.
Article
11. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993; 24:35–41.
Article
12. Cowperthwaite MC, Burnett MG. An analysis of admissions from 155 United States hospitals to determine the influence of weather on stroke incidence. J Clin Neurosci. 2011; 18:618–623.
Article
13. Ohshige K, Hori Y, Tochikubo O, Sugiyama M. Influence of weather on emergency transport events coded as stroke: population-based study in Japan. Int J Biometeorol. 2006; 50:305–311.
Article
14. Feigin VL, Nikitin YP, Bots ML, Vinogradova TE, Grobbee DE. A population-based study of the associations of stroke occurrence with weather parameters in Siberia, Russia (1982-92). Eur J Neurol. 2000; 7:171–178.
Article
15. Low RB, Bielory L, Qureshi AI, Dunn V, Stuhlmiller DF, Dickey DA. The relation of stroke admissions to recent weather, airborne allergens, air pollution, seasons, upper respiratory infections, and asthma incidence, September 11, 2001, and day of the week. Stroke. 2006; 37:951–957.
Article
16. Hong YC, Rha JH, Lee JT, Ha EH, Kwon HJ, Kim H. Ischemic stroke associated with decrease in temperature. Epidemiology. 2003; 14:473–478.
Article
17. Woodhouse PR, Khaw KT, Plummer M, Foley A, Meade TW. Seasonal variations of plasma fibrinogen and factor VII activity in the elderly: winter infections and death from cardiovascular disease. Lancet. 1994; 343:435–439.
Article
18. Keatinge WR, Coleshaw SR, Easton JC, Cotter F, Mattock MB, Chelliah R. Increased platelet and red cell counts, blood viscosity, and plasma cholesterol levels during heat stress, and mortality from coronary and cerebral thrombosis. Am J Med. 1986; 81:795–800.
Article
19. Gordon DJ, Hyde J, Trost DC, Whaley FS, Hannan PJ, Jacobs DR, et al. Cyclic seasonal variation in plasma lipid and lipoprotein levels: the Lipid Research Clinics Coronary Primary Prevention Trial Placebo Group. J Clin Epidemiol. 1988; 41:679–689.
Article
20. Otsuki T, Ishii N. Association between blood pressure changes during self-paced outdoor walking and air temperature. Clin Physiol Funct Imaging. 2015; 07. 25. [Epub]. DOI: 10.1111/cpf.12280.
Article
21. Elkind MS, Luna JM, McClure LA, Zhang Y, Coffey CS, Roldan A, et al. C-reactive protein as a prognostic marker after lacunar stroke: levels of inflammatory markers in the treatment of stroke study. Stroke. 2014; 45:707–716.
22. Elkind MS, Luna JM, Coffey CS, McClure LA, Liu KM, Spitalnik S, et al. The Levels of Inflammatory Markers in the Treatment of Stroke study (LIMITS): inflammatory biomarkers as risk predictors after lacunar stroke. Int J Stroke. 2010; 5:117–125.
Article
23. Sturgeon JD, Folsom AR, Longstreth WT Jr, Shahar E, Rosamond WD, Cushman M. Hemostatic and inflammatory risk factors for intracerebral hemorrhage in a pooled cohort. Stroke. 2008; 39:2268–2273.
Article
24. Gong C, Hoff JT, Keep RF. Acute inflammatory reaction following experimental intracerebral hemorrhage in rat. Brain Res. 2000; 871:57–65.
Article
25. Berginer VM, Goldsmith J, Batz U, Vardi H, Shapiro Y. Clustering of strokes in association with meteorologic factors in the Negev Desert of Israel: 1981-1983. Stroke. 1989; 20:65–69.
Article
26. Hales JR, Dampney RA. The redistribution of cardiac output in the dog during heat stress. J Therm Biol. 1975; 1:29–34.
Article
27. Hales JR. Effects of exposure to hot environments on the regional distribution of blood flow and on cardiorespiratory function in sheep. Pflugers Arch. 1973; 344:133–148.
Article
Full Text Links
  • JCN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr