{"title":"缺血性中风住院治疗的季节变化:来自美国西部六个州的大型卫生系统的结果","authors":"Reza Bavarsad Shahripour, Datis Azarpazhooh, Elizabeth Baraban, Horia Marginean, Sima Osouli Meinagh, Sholeh Faezi, Jasen Tarpley","doi":"10.14740/jnr745","DOIUrl":null,"url":null,"abstract":"Background: Evidence of seasonal variations in the number of stroke admission is inconsistent with some studies reporting no association and some a significant rise in different months of the year. In addition, less is known about how seasonality impacts the admission according to stroke subtype. Methods: This was a cross-sectional, observational study of data from a hospital-based registry (n = 40 hospitals) affiliated with Providence Health and Services in Alaska, California, Montana, Oregon, Texas, and Washington state. We included all cases with acute ischemic stroke admitted from March 1, 2017, to February 29, 2020. Admission data were categorized according to four meteorological seasons: winter, spring, summer, and fall. Acute ischemic stroke was categorized into two sub-types as large vessel occlusion (LVO) or non-LVO. We calculated the aggregate number of individuals admitted with stroke by season. Using linear regression models with generalized estimating equations (GEEs), we assessed the relationship between meteorological season and daily hospitalization number. We used R version 4.0.4 (2021-02-15) for both the descriptive and inferential analyses and the R gee pack package (version 1.2-1) to perform GEEs. Results: During the study period, we identified 18,886 patients with acute ischemic stroke (median age: 73; 48.7% women). Acute ischemic stroke was more commonly observed during winter compared with other seasons with some variations between the selected regions. Based on a GEE model, stroke hospitalization increased during winter, with an additional 3.3 cases per day in comparison with spring in the whole population (beta: 3.3, 95% confidence interval (CI): (2.4, 4.1), P < 0001). Winter is also associated with a higher number of LVO. Conclusions: The total number of ischemic stroke admissions, including cases of LVO, increased during the winter months. The results are important for human resource allocation for better management of cases with ischemic strokes. J Neurol Res. 2023;13(1):33-42 doi: https://doi.org/10.14740/jnr745","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Seasonal Variation in Ischemic Stroke Hospitalization: Results From a Large Health System in Six Western States of the United States\",\"authors\":\"Reza Bavarsad Shahripour, Datis Azarpazhooh, Elizabeth Baraban, Horia Marginean, Sima Osouli Meinagh, Sholeh Faezi, Jasen Tarpley\",\"doi\":\"10.14740/jnr745\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Evidence of seasonal variations in the number of stroke admission is inconsistent with some studies reporting no association and some a significant rise in different months of the year. In addition, less is known about how seasonality impacts the admission according to stroke subtype. Methods: This was a cross-sectional, observational study of data from a hospital-based registry (n = 40 hospitals) affiliated with Providence Health and Services in Alaska, California, Montana, Oregon, Texas, and Washington state. We included all cases with acute ischemic stroke admitted from March 1, 2017, to February 29, 2020. Admission data were categorized according to four meteorological seasons: winter, spring, summer, and fall. Acute ischemic stroke was categorized into two sub-types as large vessel occlusion (LVO) or non-LVO. We calculated the aggregate number of individuals admitted with stroke by season. Using linear regression models with generalized estimating equations (GEEs), we assessed the relationship between meteorological season and daily hospitalization number. We used R version 4.0.4 (2021-02-15) for both the descriptive and inferential analyses and the R gee pack package (version 1.2-1) to perform GEEs. Results: During the study period, we identified 18,886 patients with acute ischemic stroke (median age: 73; 48.7% women). Acute ischemic stroke was more commonly observed during winter compared with other seasons with some variations between the selected regions. Based on a GEE model, stroke hospitalization increased during winter, with an additional 3.3 cases per day in comparison with spring in the whole population (beta: 3.3, 95% confidence interval (CI): (2.4, 4.1), P < 0001). Winter is also associated with a higher number of LVO. Conclusions: The total number of ischemic stroke admissions, including cases of LVO, increased during the winter months. The results are important for human resource allocation for better management of cases with ischemic strokes. J Neurol Res. 2023;13(1):33-42 doi: https://doi.org/10.14740/jnr745\",\"PeriodicalId\":16489,\"journal\":{\"name\":\"Journal of Neurology Research\",\"volume\":\"12 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neurology Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14740/jnr745\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14740/jnr745","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:季节性卒中入院人数变化的证据不一致,一些研究报告没有关联,一些研究报告在一年中的不同月份显著上升。此外,季节性因素对脑卒中亚型入院的影响尚不清楚。方法:这是一项横断面观察性研究,数据来自阿拉斯加、加利福尼亚州、蒙大拿州、俄勒冈州、德克萨斯州和华盛顿州普罗维登斯健康服务中心附属的医院登记(n = 40家医院)。我们纳入了2017年3月1日至2020年2月29日收治的所有急性缺血性卒中病例。录取数据按冬、春、夏、秋四个气象季节进行分类。急性缺血性脑卒中分为大血管闭塞(LVO)和非大血管闭塞(LVO)两种亚型。我们按季节计算了中风入院的总人数。利用广义估计方程(GEEs)的线性回归模型,评估了气象季节与日住院人数之间的关系。我们使用R版本4.0.4(20121-02-15)进行描述性和推断性分析,并使用R gee pack包(版本1.2-1)执行GEEs。结果:在研究期间,我们确定了18886例急性缺血性卒中患者(中位年龄:73岁;48.7%的女性)。与其他季节相比,急性缺血性中风在冬季更为常见,并且在所选地区之间存在一定差异。根据GEE模型,冬季卒中住院人数增加,与春季相比,整个人群每天增加3.3例(β值:3.3,95%置信区间(CI):(2.4, 4.1), P <0001)。冬季也与较高的LVO数量有关。结论:缺血性卒中住院总人数,包括LVO病例,在冬季有所增加。研究结果对人力资源配置、更好地管理缺血性脑卒中病例具有重要意义。中华神经科杂志,2013;13(1):33-42 doi: https://doi.org/10.14740/jnr745
Seasonal Variation in Ischemic Stroke Hospitalization: Results From a Large Health System in Six Western States of the United States
Background: Evidence of seasonal variations in the number of stroke admission is inconsistent with some studies reporting no association and some a significant rise in different months of the year. In addition, less is known about how seasonality impacts the admission according to stroke subtype. Methods: This was a cross-sectional, observational study of data from a hospital-based registry (n = 40 hospitals) affiliated with Providence Health and Services in Alaska, California, Montana, Oregon, Texas, and Washington state. We included all cases with acute ischemic stroke admitted from March 1, 2017, to February 29, 2020. Admission data were categorized according to four meteorological seasons: winter, spring, summer, and fall. Acute ischemic stroke was categorized into two sub-types as large vessel occlusion (LVO) or non-LVO. We calculated the aggregate number of individuals admitted with stroke by season. Using linear regression models with generalized estimating equations (GEEs), we assessed the relationship between meteorological season and daily hospitalization number. We used R version 4.0.4 (2021-02-15) for both the descriptive and inferential analyses and the R gee pack package (version 1.2-1) to perform GEEs. Results: During the study period, we identified 18,886 patients with acute ischemic stroke (median age: 73; 48.7% women). Acute ischemic stroke was more commonly observed during winter compared with other seasons with some variations between the selected regions. Based on a GEE model, stroke hospitalization increased during winter, with an additional 3.3 cases per day in comparison with spring in the whole population (beta: 3.3, 95% confidence interval (CI): (2.4, 4.1), P < 0001). Winter is also associated with a higher number of LVO. Conclusions: The total number of ischemic stroke admissions, including cases of LVO, increased during the winter months. The results are important for human resource allocation for better management of cases with ischemic strokes. J Neurol Res. 2023;13(1):33-42 doi: https://doi.org/10.14740/jnr745