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Determination of the influence of weather and air constituents on aortic aneurysm ruptures. Heliyon 2022; 8:e09263. [PMID: 35450391 PMCID: PMC9018152 DOI: 10.1016/j.heliyon.2022.e09263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/22/2022] [Accepted: 04/06/2022] [Indexed: 11/29/2022] Open
Abstract
In this article, we present a method to determine the influence of meteorology and air pollutants on ruptured aortic aneurysm (rAA). In contrast to previous studies, our work takes into account highly resolved seasonal relationships, a time-lagged effect relationship of up to two weeks, and furthermore, potential confounding influences between the meteorological and air-hygienic variables are considered and eliminated using a cross-over procedure. We demonstrate the application of the method using the cities of Augsburg and Munich in southern Germany as examples, where a total of 152 rAA can be analyzed for the years 2010–2019. With the help of a Wilcoxon rank-sum test and the analysis of the atmospheric circulation, typical weather situations could be identified that have an influence on the occurrence of rAA in the southern German region. These are a rainy northwest wind-type in spring, humid weather in summer and warm southwest wind-type weather in autumn and winter. Influence of meteorology and air pollutants on ruptured aortic aneurysm (rAA). Consideration of time lags within flexible high temporal resolution analyses. Case-crossover procedure ensures that only relevant variables influence the results. Developed methodology can be applied to all regions of the world. In southern Germany, specific weather conditions significantly influence rAA.
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2
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Wu H, Wang Z, Li M, Liu Q, Liu W, Qiao Z, Bai T, Liu Y, Zhang C, Sun P, Wei S, Bai H. A systematic review and meta-analysis of seasonal and monthly variability in the incidence of acute aortic dissection. Ann Vasc Surg 2022; 85:383-394. [DOI: 10.1016/j.avsg.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 03/31/2022] [Accepted: 04/07/2022] [Indexed: 11/01/2022]
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Luo ZR, Yu LL, Huang ST, Chen LW, Chen Q. Impact of meteorological factors on the occurrence of acute aortic dissection in Fujian Province, China: a single-center seven-year retrospective study. J Cardiothorac Surg 2020; 15:178. [PMID: 32690094 PMCID: PMC7372770 DOI: 10.1186/s13019-020-01227-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/15/2020] [Indexed: 01/16/2023] Open
Abstract
Background The aim of this study was to investigate the correlation between meteorological factors and the occurrence of acute aortic dissection (AAD) in Fujian Province, China. Methods The clinical data of 2004 patients diagnosed with AAD in our hospital and the relevant local meteorological data from January 2013 to November 2019 were retrospectively analyzed. Results The incidence of AAD had a clear tendency toward concentration, and the corresponding peak in terms of the occurrence date was from January 13 to 14. The average minimum temperature, the average maximum temperature, and the average daily temperature differences on the “day with AAD” were significantly lower than those on the “day without AAD”. From 5 days to 3 days before AAD onset, the average daily temperature difference showed a downward trend, but statistical analysis showed that the average minimum, average maximum and average daily temperature differences were not significantly different from the values 5 days to 0 days before AAD onset. Conclusions The incidence of AAD is related to the season and month. The lowest average temperature may increase the incidence of AAD in patients with complicated cardiovascular diseases.
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Affiliation(s)
- Zeng-Rong Luo
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Ling-Li Yu
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shu-Ting Huang
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Liang-Wan Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Qiang Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
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4
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Mestres G, Díaz MA, Fierro A, Yugueros X, Tripodi P, Riambau V. Climatic influence on the risk of abdominal aortic aneurysm rupture. Vasc Med 2020; 25:443-449. [PMID: 32644915 DOI: 10.1177/1358863x20923399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our aim is to examine the effects of climatic conditions on the incidence of ruptured abdominal aortic aneurysms (rAAA) in Catalonia, Spain. We combined clinical data from the Public Health official registries in Catalonia, Spain (HD-MBDS) of all rAAA with local climatic data obtained from the closest meteorological station (69 stations, National Meteorological Service: MeteoCat) from 2008 to 2017. We analyzed the median, maximum, minimum, and variability of atmospheric pressure (hPa) and air temperature (°C), solar irradiation (MJ/m2), humidity (%), accumulated precipitation (mm), median wind, and maximum flaw direction and velocity (°, m/s), recorded on the days of events, the previous day, and mean results for 3, 7, and 30 days before, as well as seasonality. Seventy-five control days were randomly selected in a 1-year period around every rAAA day at the same meteorological station, and compared. A total of 717 days and locations with rAAA were identified, and 53,775 controls were randomly selected. For the rAAA days, there were significantly lower temperatures, lower solar global irradiation, and higher mean humidity levels in all time periods (p < 0.001, p < 0.001, p < 0.05); higher atmospheric pressure variability during 1 week and 1 month before (p = 0.011, p = 0.007); and they often occurred during autumn/winter (57.6%, p < 0.001). Logistic regression identified low mean temperatures on the days of ruptures and high mean humidity the week before as independent rupture predictors. In conclusion, low median temperatures the same day and high humidity during 1 week before were identified as independent predictors of rAAA occurrence. The role of climate on pathophysiologic mechanisms may require further investigation.
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Affiliation(s)
- Gaspar Mestres
- Vascular Surgery Division, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - María Alejandra Díaz
- Vascular Surgery Division, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Alejandro Fierro
- Vascular Surgery Division, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Xavier Yugueros
- Vascular Surgery Division, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Paolo Tripodi
- Vascular Surgery Division, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Vincent Riambau
- Vascular Surgery Division, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
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5
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De Donato G, Pasqui E, Chisci E, Michelagnoli S, Carbonari L, Pagliariccio G, Ercolini L, Ventoruzzo G, Ventura M, Leopardi M, Credi G, Viganò M, Antico A, Di Matteo L, Lenti M, Isernia G, Alberti D, Setacci F, Benevento D, Palasciano G, Setacci C. Influence of earthquakes on the occurrence of aortic aneurysm ruptures. INT ANGIOL 2019; 38:219-224. [PMID: 31112028 DOI: 10.23736/s0392-9590.19.04152-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Catastrophic events have been correlated to increased incidence of cardio-vascular events, but no correlation between RAA and seismic activities have ever been investigated. METHODS Hospital admissions related to RAA between January 2014 and December 2016 were retrospectively assessed in nine vascular centers of central Italy and correlated with date-matched seismic events. Correlation between RAA presentation and seismic event was first evaluated by Linear Regression analysis. Incidence of RAA events, mortality rate, and type of intervention were analyzed during seismic days (SD) and compared to outcomes during non-seismic days (nSD). RESULTS A total of 376 patients were admitted with a diagnosis of RAA, and a total of 783 seismic events were reviewed. Twenty patients died before intervention (untreated). Open surgery was performed in 72.8%, endovascular treatment in 27.2%. General mortality at 30 days was 26.6% (30.5% for open surgery; 21.6% for endovascular treatment; P=0.24). Linear regression analysis between RAA and seismic periods revealed a significant correlation (slope=0.11±0.04, equation: y = 0.1143 x + 3.034, P=0.02). Incidence of RAA was 0.34 event per day during the entire period, 0.32 during nSD and 0.44 during SD (P=0.006). During seismic days, patients with RAA were older (80.5 years during SD vs. 77 years during nSD, P=0.12), were in poorer general condition at admission and remained untreated more frequently (8% SD vs. 4.7% nSD, P=0.3), and had a higher mortality rate at 30 days (46.2% SD vs. 27.2% nSD, P=0.012). CONCLUSIONS During seismic days, the incidence of RAA is higher in comparison to non-seismic days. Patients with rupture during seismic days have a higher risk of death.
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Affiliation(s)
- Gianmarco De Donato
- Division of Vascular Surgery, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy -
| | - Edoardo Pasqui
- Division of Vascular Surgery, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Emiliano Chisci
- Unit of Vascular Surgery, San Giovanni di Dio Hospital, Florence, Italy
| | | | | | | | | | | | - Marco Ventura
- Unit of Vascular Surgery, San Salvatore Hospital, L'Aquila, Italy
| | - Marco Leopardi
- Unit of Vascular Surgery, San Salvatore Hospital, L'Aquila, Italy
| | - Giovanni Credi
- Unit of Vascular Surgery, Hospital of Massa Carrara, Massa Carrara, Italy
| | - Massimo Viganò
- Unit of Vascular Surgery, Hospital of Massa Carrara, Massa Carrara, Italy
| | - Antonio Antico
- Unit of Vascular Surgery, Santo Spirito Civil Hospital, Pescara, Italy
| | - Luigi Di Matteo
- Unit of Vascular Surgery, Santo Spirito Civil Hospital, Pescara, Italy
| | - Massimo Lenti
- Unit of Vascular Surgery, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Giacomo Isernia
- Unit of Vascular Surgery, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Domenico Alberti
- Unit of Vascular Surgery, Santa Maria Civil Hospital, Terni, Italy
| | - Francesco Setacci
- Unit of Vascular Surgery, Multimedica Institute for Research and Care, Milan, Italy
| | - Domenico Benevento
- Division of Vascular Surgery, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Giancarlo Palasciano
- Division of Vascular Surgery, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Carlo Setacci
- Division of Vascular Surgery, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
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Choong AMTL, Marjot J, Wee IJY, Syn N, Marjot T, Brightwell RE, Walker PJ. Forecasting aortic aneurysm rupture: A systematic review of seasonal and atmospheric associations. J Vasc Surg 2019; 69:1615-1632.e17. [PMID: 30792059 DOI: 10.1016/j.jvs.2018.09.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 09/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Abdominal aortic aneurysms (AAAs) represent a significant burden of disease worldwide, and their rupture, without treatment, has an invariably high mortality rate. Whereas some risk factors for ruptured AAAs (rAAAs) are well established, such as hypertension, smoking, and female sex, the impact of seasonal and meteorologic variables is less clear. We systematically reviewed the literature to determine whether these variables are associated with rAAA. METHODS Review methods were according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We calculated pooled proportions and incidence rate ratios (IRRs) for the different months and seasons. Funnel plots were constructed to assess for publication bias. Given the poor methodologic quality of included studies, a sensitivity analysis was performed on better-quality studies, which scored 6 and above of 9 in the author-modified Newcastle-Ottawa Scale. RESULTS The pooled proportion of rAAA was highest in the autumn season (incidence rate, 26.6%; 95% confidence interval [CI], 25.6%-27.7%; I2 = 15.4%), followed by winter (incidence rate, 26.2%; 95% CI, 24.1%-28.2%; I2 = 72.4%), and lowest in summer (incidence rate, 21.1%; 95% CI, 19.3%-23.0%; I2 = 70.4%). The IRRs of rAAA were -6.9% (95% CI, -9.8% to -3.9%), -19.5% (95% CI, -22% to -16.8%), +10.5% (95% CI, 7.2%-13.9%), and +18.1% (95% CI, 15%-22%) in spring, summer, autumn, and winter compared with the remaining seasons, respectively (all P < .0001), thus affirming existence of seasonal variation. The pooled proportion of rAAA was highest in December (incidence rate, 8.9%; 95% CI, 7.1%-10.9%; I2 = 54.5%) but lowest in July (incidence rate, 5.7%; 95% CI, 4.2%-7.3%; I2 = 54.5%). The IRR was significantly the highest in January (IRR, 1.14; 95% CI, 1.01-1.29; P = .031) but lowest in July (IRR, 0.75; 95% CI, 0.65-0.87; P < .0001). There is also some evidence for a possible association with atmospheric pressure. Associations with temperature and daylight hours, however, are at best speculative. CONCLUSIONS Autumn and winter are significantly associated with a higher incidence of rAAAs, and autumn is associated with the highest rupture incidence of all the seasons. However, the inability to appropriately control for other confounding factors known to increase the risk of AAA rupture precludes any additional recommendations to alter current provision of vascular services on the basis of these data.
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Affiliation(s)
- Andrew M T L Choong
- SingVaSC, Singapore Vascular Surgical Collaborative, National University of Singapore, Singapore; Cardiovascular Research Institute, National University of Singapore, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Vascular Surgery, National University Heart Centre, Singapore.
| | - Jack Marjot
- SingVaSC, Singapore Vascular Surgical Collaborative, National University of Singapore, Singapore; Prince of Wales Hospital, Sydney, Australia
| | - Ian J Y Wee
- SingVaSC, Singapore Vascular Surgical Collaborative, National University of Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas Syn
- SingVaSC, Singapore Vascular Surgical Collaborative, National University of Singapore, Singapore
| | - Tom Marjot
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Robert E Brightwell
- SingVaSC, Singapore Vascular Surgical Collaborative, National University of Singapore, Singapore; Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom
| | - Philip J Walker
- Department of Surgery, University of Queensland, Brisbane, Australia; Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Wu Z, Li Y, Zhou W, Ji C, Zhao H, Liu X, Han Y. Seasonal incidence of ruptured abdominal aortic aneurysm and the influence of atmospheric pressure: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:1733-1743. [PMID: 29943073 DOI: 10.1007/s00484-018-1573-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/10/2018] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
Abstract
Ruptured abdominal aortic aneurysm (rAAA) is a life-threatening condition with a high mortality rate. Seasonal variations in the incidence of rAAA and the influence of atmospheric pressure have been studied throughout decades; however, the conclusions are contradictory. Therefore, we aimed to conduct a meta-analysis and systematic review of literature on seasonal variations in rAAA incidence and the influence of atmospheric pressure. Studies investigating seasonal variations in rAAA incidence and influence of atmospheric pressure were retrieved. For dichotomous data, we generated risk ratios (RRs) and 95% confidence intervals (CIs) for rAAA incidence compared among seasons. The studies were subdivided according to latitude, elevation, and climatic types, for subgroup comparisons. Studies reporting monthly incidence and seasonal mortality were further investigated. For continuous data, standardized mean differences (SMDs) and 95% CIs were generated for atmospheric pressure comparisons. Twenty-four eligible studies were included, comprising a total of 38,506 patients with rAAA. Pooled rAAA incidence was 25% in spring, 23% in summer, 26% in autumn, and 26% in winter. Pooled analysis demonstrated a statistically significant higher rAAA incidence in winter than in summer (RR 1.10, P = 0.04) and in autumn than in summer (RR 1.11, P < 0.00001). However, there was no statistically significant difference among other seasons. In the study of the influence of atmospheric pressure, no statistically significant difference was observed. In conclusion, our study revealed a higher incidence of rAAA in autumn and winter than in summer; however, atmospheric pressure was found to exert no influence.
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Affiliation(s)
- Zhiyuan Wu
- Department of General Surgery, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Shenyang, 110000, China
| | - Yeni Li
- Liaoning Provincial Meteorological Training Center, Liaoning Branch of China Meteorological Administration Training Center (CMATC), Shenyang, China
| | - Wenlong Zhou
- Department of General Surgery, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Shenyang, 110000, China
| | - Chao Ji
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Haibin Zhao
- Department of Emergency, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xun Liu
- Department of General Surgery, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Shenyang, 110000, China
| | - Yanshuo Han
- Department of General Surgery, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Shenyang, 110000, China.
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Ferrazzi E, Romualdi C, Ocello M, Frighetto G, Turco M, Vigolo S, Fabris F, Angeli P, Vettore G, Costa R, Montagnese S. Changes in Accident & Emergency Visits and Return Visits in Relation to the Enforcement of Daylight Saving Time and Photoperiod. J Biol Rhythms 2018; 33:555-564. [PMID: 30056770 DOI: 10.1177/0748730418791097] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Daylight saving time (DST) is a source of circadian disruption impinging on millions of people every year. Our aim was to assess modifications, if any, in the number, type, and outcome of Accident & Emergency (A&E) visits/return visits over the DST months. The study included 366,527 visits and 84,380 return visits to the A&E of Padova hospital (Northern Italy) over 3 periods between the years 2007 and 2016: period 1 (2 weeks prior to DST to 19 weeks after), period 2 (2 weeks prior to the return to "winter time" to 4 weeks after), and period 3 (5 consecutive non-DST weeks). For each A&E visit/return visit, information was obtained on triage severity code, main medical complaint, and outcome. Data were aggregated by day, cumulated over the years, and analyzed by generalized Poisson models. Generalized additive models for Poisson data were then used to include photoperiod as an additional covariate. An increase in A&E visits and return visits (mostly white codes, resulting in discharges) was observed a few weeks after the enforcement of DST and was significant over most weeks of period 1 (increase of ≈30 [2.8%] visits and ≈25 [10%] return visits per week per year). After the return to winter time, a decrease in absolute number of return visits was observed (mostly white codes, resulting in discharges), which was significant at weeks 3 and 4 of period 2 (decrease of ≅25 [10%] return visits per week per year). When photoperiod was taken into account, changes in A&E visits (and related white codes/discharges) were no longer significant, while changes in return visits (and related white codes/discharges) were still significant. In conclusion, changes in A&E visits/return visits were observed in relation to both DST and photoperiod, which are worthy of further study and could lead to modifications in A&E organization/staffing.
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Affiliation(s)
- Elena Ferrazzi
- 1. Emergency Department, Mestre Dell'Angelo Hospital, ULSS3 Serenissima, Mestre, Italy.,Department of Medicine, University of Padova, Padova, Italy.,Emergency Department, Padova University Hospital, Padova, Italy
| | | | - Michele Ocello
- Department of Medicine, University of Padova, Padova, Italy
| | - Giovanni Frighetto
- 2. Department of General Psychology, University of Padova, Padova, Italy.,Department of Medicine, University of Padova, Padova, Italy
| | - Matteo Turco
- Department of Medicine, University of Padova, Padova, Italy
| | - Stefania Vigolo
- Department of Medicine, University of Padova, Padova, Italy.,Emergency Department, Padova University Hospital, Padova, Italy
| | | | - Paolo Angeli
- Department of Medicine, University of Padova, Padova, Italy
| | - Gianna Vettore
- Emergency Department, Padova University Hospital, Padova, Italy
| | - Rodolfo Costa
- Department of Medicine, University of Padova, Padova, Italy
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Opacic D, Ilic N, Sladojevic M, Schönleitner P, Markovic D, Kostic D, Davidovic L. Effects of atmospheric pressure dynamics on abdominal aortic aneurysm rupture onset. VASA 2018; 47:137-142. [PMID: 29299980 DOI: 10.1024/0301-1526/a000681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The effect of atmospheric pressure (AP) on the onset of abdominal aorta aneurysm rupture (RAAA) remains an unanswered question. We have investigated the seasonal variation and the effect of AP dynamics on RAAA by analysing the largest series of intraoperatively confirmed RAAA. PATIENTS AND METHODS To realize this study we have performed a retrospective analysis of 546 patients with RAAA, operated within 503 days at the Clinic for vascular and endovascular surgery CCS between 1.1.2003 and 31.12.2012. AP data for Belgrade city were obtained from meteorological yearbooks published by the Republic Hydrometeorological Service of Serbia measured at the hydrometeorological station "Belgrade Observatory". Only patients with a residence within the extended Belgrade region, exposed to the similar AP values, were included in the analysis of the AP effect on RAAA. RESULTS RAAA were observed more frequently during winter and autumn months but without significant difference in comparison to other seasons. Months with higher AP values were associated with a higher RAAA rate (p = 0.0008, R2 = 0.665). A similar trend was observed for the monthly AP variability (p = 0.0311, R2 = 0.374). Average AP values did not differ between days with and without RAAA. However, during the three and seven days periods preceding RAAA AP variability parameters were greater and AP was rising. CONCLUSIONS Although these pressure differences are very small, higher AP values over longer periods of time as well as greater variability are associated with RAAA. The exact mechanism behind this association remains unclear. The postulation that low AP may precipitate RAAA based on the Laplace law should be discarded.
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Affiliation(s)
- Dragan Opacic
- 1 Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
| | - Nikola Ilic
- 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,3 Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Milos Sladojevic
- 3 Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | | | - Dragan Markovic
- 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,3 Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Dusan Kostic
- 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,3 Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Lazar Davidovic
- 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,3 Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
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12
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Penning de Vries BBL, Kolkert JLP, Meerwaldt R, Groenwold RHH. Atmospheric Pressure and Abdominal Aortic Aneurysm Rupture: Results From a Time Series Analysis and Case-Crossover Study. Vasc Endovascular Surg 2017; 51:441-446. [PMID: 28741441 PMCID: PMC5613808 DOI: 10.1177/1538574417713909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Associations between atmospheric pressure and abdominal aortic aneurysm (AAA) rupture risk have been reported, but empirical evidence is inconclusive and largely derived from studies that did not account for possible nonlinearity, seasonality, and confounding by temperature. METHODS Associations between atmospheric pressure and AAA rupture risk were investigated using local meteorological data and a case series of 358 patients admitted to hospital for ruptured AAA during the study period, January 2002 to December 2012. Two analyses were performed-a time series analysis and a case-crossover study. RESULTS Results from the 2 analyses were similar; neither the time series analysis nor the case-crossover study showed a significant association between atmospheric pressure ( P = .627 and P = .625, respectively, for mean daily atmospheric pressure) or atmospheric pressure variation ( P = .464 and P = .816, respectively, for 24-hour change in mean daily atmospheric pressure) and AAA rupture risk. CONCLUSION This study failed to support claims that atmospheric pressure causally affects AAA rupture risk. In interpreting our results, one should be aware that the range of atmospheric pressure observed in this study is not representative of the atmospheric pressure to which patients with AAA may be exposed, for example, during air travel or travel to high altitudes in the mountains. Making firm claims regarding these conditions in relation to AAA rupture risk is difficult at best. Furthermore, despite the fact that we used one of the largest case series to date to investigate the effect of atmospheric pressure on AAA rupture risk, it is possible that this study is simply too small to demonstrate a causal link.
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Affiliation(s)
- Bas B. L. Penning de Vries
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joé L. P. Kolkert
- Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Robbert Meerwaldt
- Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Rolf H. H. Groenwold
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Rodó X, Ballester J, Curcoll R, Boyard-Micheau J, Borràs S, Morguí JA. Revisiting the role of environmental and climate factors on the epidemiology of Kawasaki disease. Ann N Y Acad Sci 2016; 1382:84-98. [PMID: 27603178 DOI: 10.1111/nyas.13201] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/03/2016] [Accepted: 07/14/2016] [Indexed: 12/16/2022]
Abstract
Can environmental factors, such as air-transported preformed toxins, be of key relevance to the health outcomes of poorly understood human ailments (e.g., rheumatic diseases such as vasculitides, some inflammatory diseases, or even severe childhood acquired heart diseases)? Can the physical, chemical, or biological features of air masses be linked to the emergence of diseases such as Kawasaki disease (KD), Henoch-Schönlein purpura, Takayasu's aortitis, and ANCA-associated vasculitis? These diseases surprisingly share some common epidemiological features. For example, they tend to appear as clusters of cases grouped geographically and temporarily progress in nonrandom sequences that repeat every year in a similar way. They also show concurrent trend changes within regions in countries and among different world regions. In this paper, we revisit transdisciplinary research on the role of environmental and climate factors in the epidemiology of KD as a paradigmatic example of this group of diseases. Early-warning systems based on environmental alerts, if successful, could be implemented as a way to better inform patients who are predisposed to, or at risk for, developing KD. Further research on the etiology of KD could facilitate the development of vaccines and specific medical therapies.
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Affiliation(s)
- Xavier Rodó
- Institut Català de Ciències del Clima (IC3).,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
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Taheri Shahraiyni H, Sodoudi S, Cubasch U. Weather conditions and their effect on the increase of the risk of type A acute aortic dissection onset in Berlin. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:1303-1305. [PMID: 26546312 DOI: 10.1007/s00484-015-1099-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 10/23/2015] [Accepted: 10/23/2015] [Indexed: 06/05/2023]
Abstract
In this study, a minimum distance classification and forward feature selection technique are joined to determine the relationship between weather conditions and the increase of the risk of type A acute aortic dissection (AAD) events in Berlin. The results demonstrate that changes in the amount of cloudiness and air temperature are the most representative weather predictors among the studied parameters. A discrimination surface was developed for the prediction of AAD events 6 h ahead, and it is found that, under a specific amount of cloudiness and air temperature, the risk of AAD events in Berlin increases about 20 %.
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Affiliation(s)
- Hamid Taheri Shahraiyni
- Institut für Meteorologie, Freie Universität Berlin, Carl-Heinrich-Becker-Weg 6-10, 12165, Berlin, Germany.
- Remote Sensing Research Center, Sharif University of Technology, Tehran, Iran.
| | - Sahar Sodoudi
- Institut für Meteorologie, Freie Universität Berlin, Carl-Heinrich-Becker-Weg 6-10, 12165, Berlin, Germany
| | - Ulrich Cubasch
- Institut für Meteorologie, Freie Universität Berlin, Carl-Heinrich-Becker-Weg 6-10, 12165, Berlin, Germany
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Shiue I, Perkins DR, Bearman N. Hospital admissions due to diseases of arteries and veins peaked at physiological equivalent temperature -10 to 10 °C in Germany in 2009-2011. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:6159-6167. [PMID: 26631019 PMCID: PMC4820476 DOI: 10.1007/s11356-015-5791-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 11/10/2015] [Indexed: 06/05/2023]
Abstract
We aimed to understand relationships of the weather as biometeorological and hospital admissions due to diseases of arteries and veins by subtypes, which have been scarcely studied, in a national setting in recent years. This is an ecological study. Ten percent of daily hospital admissions from the included hospitals (n = 1,618) across Germany that were available between 1 January 2009 and 31 December 2011 (n = 5,235,600) were extracted from Statistisches Bundesamt, Germany. We identified I70-I79 Diseases of arteries, arterioles and capillaries and I80-I89 Diseases of veins, lymphatic vessels and lymph nodes by International Classification of Diseases version 10 as the study outcomes. Daily weather data from 64 weather stations that covered 13 German states including air temperature, humidity, wind speed, cloud cover, radiation flux and vapour pressure were obtained and generated into physiologically equivalent temperature (PET). Two-way fractional-polynomial prediction was plotted with 95 % confidence intervals. For most of the subtypes from diseases of arteries and veins, hospital admissions slightly peaked in spring and dropped when PET was at 10 °C. There were no other large differences across 12 months. Admissions of peripheral vascular diseases, arterial embolism and thrombosis, phlebitis and thrombophlebitis, oesophageal varices and nonspecific lymphadenitis peaked when PET was between 0 and -10 °C, while others peaked when PET was between 0 and 10 °C. More medical resources could have been needed on days when PETs were at -10 to 10 °C than on other days. Adaptation to such weather change for health professionals and the general public would seem to be imperative.
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Affiliation(s)
- Ivy Shiue
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, England, UK.
- Owens Institute of Behavioral Research, University of Georgia, Athens, USA.
| | - David R Perkins
- Center for Climate Change Communication, George Mason University, Fairfax, USA
| | - Nick Bearman
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
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Air travel of patients with abdominal aortic aneurysm: urgent air medical evacuation and nonurgent commercial air repatriation. Air Med J 2015; 33:109-11. [PMID: 24787514 DOI: 10.1016/j.amj.2014.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/30/2014] [Accepted: 02/09/2014] [Indexed: 11/21/2022]
Abstract
Abdominal aortic aneurysm (AAA) presents across a spectrum of severity. Although some resources suggest a theoretic risk for rupture related to air travel, this claim remains unproven. In fact, there are little data from which to make evidence-based recommendations. Air medical evacuation of a patient with either an AAA at risk of imminent rupture or status post recent rupture can be performed, assuming that local surgical care is not available and that transfer is taking the patient to a higher level of medical intervention. Furthermore, medical opinion suggests that patients with asymptomatic and/or surgically corrected AAA can safely travel by commercial aircraft for nonurgent reasons, assuming that other issues including postoperative needs are appropriately addressed. In this discussion, answers to the following issues are sought: flight safety for urgent evacuation and nonurgent repatriation scenarios, waiting time to fly nonurgently after AAA diagnosis, and the need for medical accompaniment.
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