AUTHOR=Zhao Jinhua , Zhang Yongming , Ni Ying , He Junyu , Wang Jianping , Li Xuan , Guo Yuming , Li Changping , Zhang Wenyi , Cui Zhuang TITLE=Effect of ambient temperature and other environmental factors on stroke emergency department visits in Beijing: A distributed lag non-linear model JOURNAL=Frontiers in Public Health VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1034534 DOI=10.3389/fpubh.2022.1034534 ISSN=2296-2565 ABSTRACT=Background

Most studies have focused on the relationship between ambient temperature and stroke mortality, but studies on the relationship between ambient temperature and stroke occurrence are still limited and inconsistent.

Objective

This study aimed to analyze the effect of ambient temperature and other environmental factors on emergency stroke visits in Beijing.

Methods

Our study utilized stroke visit data from the Beijing Red Cross Emergency Medical Center during 2017–2018, and applied a generalized additive model (GAM) as well as a distributed lag non-linear model (DLNM), respectively, regarding the direct, lagged, and cumulative effects of ambient temperature alone and with correction for other environmental factors on stroke occurrence.

Results

With a total of 26,984 emergency stroke patients in 2017–2018, both cold and hot effects were observed and weakened after correction for other environmental factors. Compared to the reference temperature, in the multi-factor model, extreme cold (−10°C) reached a maximum relative risk (RR) of 1.20 [95% Confidence Interval (CI): 1.09, 1.32] at lag 14 days, and extreme hot (30°C) had a maximum RR of 1.07 (95% CI: 1.04, 1.11) at lag 6 days. The cumulative effect of extreme cold reached a maximum of 2.02 (95% CI: 1.11, 3.67) at lag 0–14 days, whereas the cumulative effect of extreme hot temperature is greatest at lag 0–10 days, but no statistically significant effect was found. In addition, ischemic stroke patients, the elderly, and males were more susceptible to the effects of cold temperature.

Conclusions

There is a non-linear relationship between ambient temperature and stroke occurrence, with cold temperature having a greater and longer-lasting impact than hot temperature.