Impact of extreme temperature on congenital heart disease mortality: a population-based nationwide case-crossover study

IF 7.6 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet Regional Health: Western Pacific Pub Date : 2024-12-01 DOI:10.1016/j.lanwpc.2024.101244

Qiyu He , Xinyue Lang , Huayan Shen , Jiangmei Liu , Sirui Zhou , Jing Wei , Xinjie Lin , Yuze Liu , Kai Ma , Zheng Dou , Zhou Zhou , Maigeng Zhou , Shoujun Li

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引用次数: 0

Abstract

Background

The association between congenital heart disease (CHD) and non-optimal temperatures has received limited investigation. We aimed to investigate the impact of extreme temperatures on CHD mortality.

Methods

We reviewed the National Mortality Surveillance System of China and retrieved death records attributable to CHD from 2013 to 2021. Temperature and air pollutants data were obtained from the ERA5-Land reanalysis dataset and the ChinaHighAirPollutants database. A two-stage case-crossover study design was implemented. Sensitivity and subgroup analyses were performed to test the robustness of findings and determine the vulnerable population.

Findings

A total of 32,168 CHD deaths were included, showing a significant association between cold and CHD mortality, while there was little effect for heat. The odd ratio (OR) ranged from 1.05 (95% confidence interval: 1.00–1.10) to 1.15 (1.03–1.29) across country, with a more pronounced impact in non-monsoon regions up to 1.67 (1.20–2.32). Cold extremes accounted for an attributable fraction of 4.09 per 1000 CHD death nationwide and 13.30 per 1000 CHD deaths in non-monsoon regions. Sensitivity analyses utilizing apparent temperature and adjusting for air pollutants confirmed the robustness of the main findings. Female and pediatric CHD patients were identified as the vulnerable population to cold extremes.

Interpretation

For the first time, this nationwide study demonstrated the significant impact of cold extremes on CHD mortality, particularly in non-monsoon regions, and among female and pediatric subgroups. These findings may suggest that healthcare professionals advise CHD patients to avoid exposure to cold extremes, and provide insight into healthcare policy adjustment.

Funding

This study was supported by the CAMS Innovation Fund for Medical Sciences (CIFMS, 2023-I2M-C&T-B-059), the Capital Health Research and Development of Special Fund (2022-1-4032) and the National High Level Hospital Research Funding (2022-GSP-GG-19).

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来源期刊

The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health

CiteScore

8.80

自引率

2.80%

发文量

305

审稿时长

11 weeks

期刊介绍： The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.