Impact of temperature decline from the previous day as a trigger of spontaneous subarachnoid hemorrhage: case-crossover study of prefectural stroke database

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  • 1 Department of Neurosurgery and
  • 2 Integrated Center for Advanced Medical Technologies, Kochi University Hospital;
  • 3 Department of Neurosurgery, Kochi Health Sciences Center;
  • 4 Department of Neurosurgery, Chikamori Hospital;
  • 5 Department of Neurosurgery, Kochi Red Cross Hospital;
  • 6 Department of Neurosurgery, Hata Kenmin Hospital;
  • 7 Department of Neurosurgery, Mominoki Hospital, Kochi, Japan; and
  • 8 Department of Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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OBJECTIVE

Several environmental factors have been reported to correlate with incidence of spontaneous subarachnoid hemorrhage (SAH). However, because of different patient selection and study designs among these studies, meteorological factors that trigger the incidence of SAH in a short hazard period remain unknown. Among meteorological factors, daily temperature changes may disrupt and violate homeostasis and predispose to cerebrovascular circulatory disturbances and strokes. The authors aimed to investigate whether a decline in the temperature from the highest of the previous day to the lowest of the event day (temperature decline from the previous day [TDP]) triggers SAH in the prefecture-wide stroke database.

METHODS

All 28 participating institutions with primary or comprehensive stroke centers located throughout Kochi Prefecture, Japan, were included in the study. Data collected between January 2012 and December 2016 were analyzed, and 715 consecutive SAH patients with a defined date of onset were enrolled. Meteorological data in this period were obtained from the Kochi Local Meteorological Observatory. A case-crossover study was performed to investigate association of TDP and other environmental factors with onset of SAH.

RESULTS

The increasing TDP in 1°C on the day of the SAH event was associated with an increased incidence of SAH (OR 1.041, 95% CI 1.007–1.077) after adjustment for other environmental factors. According to the stratified analysis, a significant association between TDP and SAH was observed in women, patients < 65 years old, and patients with weekday onset. Among these factors, increasing TDP had a great impact on SAH onset in patients < 65 years old (p = 0.028, Mann-Whitney U-test).

CONCLUSIONS

TDP, temperature decline from the highest of the previous day to the lowest of the day, was correlated with the incidence of spontaneous SAH, particularly in younger patients < 65 years old.

ABBREVIATIONS CI = confidence interval; IQR = interquartile range; KATSUO = Kochi Acute Stroke Survey of Onset; OR = odds ratio; SAH = subarachnoid hemorrhage; TDP = temperature decline from the previous day.

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Contributor Notes

Correspondence Hitoshi Fukuda: Kochi University Hospital, Kochi, Japan. fukudaharpseal@gmail.com.

INCLUDE WHEN CITING Published online July 5, 2019; DOI: 10.3171/2019.4.JNS19175.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

  • 1

    Abe T, Ohde S, Ishimatsu S, Ogata H, Hasegawa T, Nakamura T, : Effects of meteorological factors on the onset of subarachnoid hemorrhage: a time-series analysis. J Clin Neurosci 15:10051010, 2008

    • Search Google Scholar
    • Export Citation
  • 2

    Backes D, Rinkel GJ, Algra A, Vaartjes I, Donker GA, Vergouwen MD: Increased incidence of subarachnoid hemorrhage during cold temperatures and influenza epidemics. J Neurosurg 125:737745, 2016

    • Search Google Scholar
    • Export Citation
  • 3

    Beseoglu K, Hänggi D, Stummer W, Steiger HJ: Dependence of subarachnoid hemorrhage on climate conditions: a systematic meteorological analysis from the Dusseldorf metropolitan area. Neurosurgery 62:10331039, 2008

    • Search Google Scholar
    • Export Citation
  • 4

    Boswell S, Thorell W, Gogela S, Lyden E, Surdell D: Angiogram-negative subarachnoid hemorrhage: outcomes data and review of the literature. J Stroke Cerebrovasc Dis 22:750757, 2013

    • Search Google Scholar
    • Export Citation
  • 5

    Brennan PJ, Greenberg G, Miall WE, Thompson SG: Seasonal variation in arterial blood pressure. Br Med J (Clin Res Ed) 285:919923, 1982

    • Search Google Scholar
    • Export Citation
  • 6

    Broderick JP, Viscoli CM, Brott T, Kernan WN, Brass LM, Feldmann E, : Major risk factors for aneurysmal subarachnoid hemorrhage in the young are modifiable. Stroke 34:13751381, 2003

    • Search Google Scholar
    • Export Citation
  • 7

    Buxton N, Liu C, Dasic D, Moody P, Hope DT: Relationship of aneurysmal subarachnoid hemorrhage to changes in atmospheric pressure: results of a prospective study. J Neurosurg 95:391392, 2001

    • Search Google Scholar
    • Export Citation
  • 8

    Castellani JW, Young AJ: Human physiological responses to cold exposure: acute responses and acclimatization to prolonged exposure. Auton Neurosci 196:6374, 2016

    • Search Google Scholar
    • Export Citation
  • 9

    Cowperthwaite MC, Burnett MG: The association between weather and spontaneous subarachnoid hemorrhage: an analysis of 155 US hospitals. Neurosurgery 68:132139, 2011

    • Search Google Scholar
    • Export Citation
  • 10

    Donaldson GC, Ermakov SP, Komarov YM, McDonald CP, Keatinge WR: Cold related mortalities and protection against cold in Yakutsk, eastern Siberia: observation and interview study. BMJ 317:978982, 1998

    • Search Google Scholar
    • Export Citation
  • 11

    The Eurowinter Group: Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe. Lancet 349:13411346, 1997

    • Search Google Scholar
    • Export Citation
  • 12

    Fann JR, Kukull WA, Katon WJ, Longstreth WT Jr: Physical activity and subarachnoid haemorrhage: a population based case-control study. J Neurol Neurosurg Psychiatry 69:768772, 2000

    • Search Google Scholar
    • Export Citation
  • 13

    Feigin VL, Anderson CS, Anderson NE, Broad JB, Pledger MJ, Bonita R: Is there a temporal pattern in the occurrence of subarachnoid hemorrhage in the southern hemisphere? Pooled data from 3 large, population-based incidence studies in Australasia, 1981 to 1997. Stroke 32:613619, 2001

    • Search Google Scholar
    • Export Citation
  • 14

    Giaconi S, Ghione S, Palombo C, Genovesi-Ebert A, Marabotti C, Fommei E, : Seasonal influences on blood pressure in high normal to mild hypertensive range. Hypertension 14:2227, 1989

    • Search Google Scholar
    • Export Citation
  • 15

    Gill RS, Hambridge HL, Schneider EB, Hanff T, Tamargo RJ, Nyquist P: Falling temperature and colder weather are associated with an increased risk of aneurysmal subarachnoid hemorrhage. World Neurosurg 79:136142, 2013

    • Search Google Scholar
    • Export Citation
  • 16

    Hong YC, Rha JH, Lee JT, Ha EH, Kwon HJ, Kim H: Ischemic stroke associated with decrease in temperature. Epidemiology 14:473478, 2003

    • Search Google Scholar
    • Export Citation
  • 17

    Inagawa T: Seasonal variation in the incidence of aneurysmal subarachnoid hemorrhage in hospital- and community-based studies. J Neurosurg 96:497509, 2002

    • Search Google Scholar
    • Export Citation
  • 18

    Jakovljević D, Salomaa V, Sivenius J, Tamminen M, Sarti C, Salmi K, : Seasonal variation in the occurrence of stroke in a Finnish adult population. The FINMONICA Stroke Register. Finnish Monitoring Trends and Determinants in Cardiovascular Disease. Stroke 27:17741779, 1996

    • Search Google Scholar
    • Export Citation
  • 19

    Janes H, Sheppard L, Lumley T: Case-crossover analyses of air pollution exposure data: referent selection strategies and their implications for bias. Epidemiology 16:717726, 2005

    • Search Google Scholar
    • Export Citation
  • 20

    Kario K, Pickering TG, Umeda Y, Hoshide S, Hoshide Y, Morinari M, : Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation 107:14011406, 2003

    • Search Google Scholar
    • Export Citation
  • 21

    Keatinge WR, Coleshaw SR, Cotter F, Mattock M, Murphy M, Chelliah R: Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling: factors in mortality from coronary and cerebral thrombosis in winter. Br Med J (Clin Res Ed) 289:14051408, 1984

    • Search Google Scholar
    • Export Citation
  • 22

    Kelsey RM, Patterson SM, Barnard M, Alpert BS: Consistency of hemodynamic responses to cold stress in adolescents. Hypertension 36:10131017, 2000

    • Search Google Scholar
    • Export Citation
  • 23

    Kochi Prefectural Office (Japan): Situation of Emergency Transfer in Kochi Prefecture. Kochi, Japan: The Institute of Health, Department of Health Policy in Kochi Prefectural Office (http://www.pref.kochi.lg.jp/soshiki/131301) [Accessed May 13, 2019]

    • Export Citation
  • 24

    Kochi Prefectural Office (Japan): Weekly Infectious Disease Information in Kochi Prefecture. Kochi, Japan: The Institute of Health, Department of Health Policy in Kochi Prefectural Office (http://www.pref.kochi.lg.jp/soshiki/130120/kansenshouzyouhou.html) [Accessed May 13, 2019]

    • Export Citation
  • 25

    Landers AT, Narotam PK, Govender ST, van Dellen JR: The effect of changes in barometric pressure on the risk of rupture of intracranial aneurysms. Br J Neurosurg 11:191195, 1997

    • Search Google Scholar
    • Export Citation
  • 26

    Lee S, Guth M: Associations between temperature and hospital admissions for subarachnoid hemorrhage in Korea. Int J Environ Res Public Health 14:E449, 2017

    • Search Google Scholar
    • Export Citation
  • 27

    Lejeune JP, Vinchon M, Amouyel P, Escartin T, Escartin D, Christiaens JL: Association of occurrence of aneurysmal bleeding with meteorologic variations in the north of France. Stroke 25:338341, 1994

    • Search Google Scholar
    • Export Citation
  • 28

    Maclure M: The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol 133:144153, 1991

    • Search Google Scholar
    • Export Citation
  • 29

    Martinez-Nicolas A, Meyer M, Hunkler S, Madrid JA, Rol MA, Meyer AH, : Daytime variation in ambient temperature affects skin temperatures and blood pressure: ambulatory winter/summer comparison in healthy young women. Physiol Behav 149:203211, 2015

    • Search Google Scholar
    • Export Citation
  • 30

    Meteorological Agency (Japan): Weather Observation. Tokyo: Meteorological Agency (www.data.jma.go.jp/gmd/risk/obsdl/) [Accessed May 13, 2019]

    • Export Citation
  • 31

    Modesti PA, Morabito M, Bertolozzi I, Massetti L, Panci G, Lumachi C, : Weather-related changes in 24-hour blood pressure profile: effects of age and implications for hypertension management. Hypertension 47:155161, 2006

    • Search Google Scholar
    • Export Citation
  • 32

    Mukai T, Hosomi N, Tsunematsu M, Sueda Y, Shimoe Y, Ohshita T, : Various meteorological conditions exhibit both immediate and delayed influences on the risk of stroke events: the HEWS-stroke study. PLoS One 12:e0178223, 2017

    • Search Google Scholar
    • Export Citation
  • 33

    Murakami S, Otsuka K, Kono T, Soyama A, Umeda T, Yamamoto N, : Impact of outdoor temperature on prewaking morning surge and nocturnal decline in blood pressure in a Japanese population. Hypertens Res 34:7073, 2011

    • Search Google Scholar
    • Export Citation
  • 34

    Omama S, Yoshida Y, Ogawa A, Onoda T, Okayama A: Differences in circadian variation of cerebral infarction, intracerebral haemorrhage and subarachnoid haemorrhage by situation at onset. J Neurol Neurosurg Psychiatry 77:13451349, 2006

    • Search Google Scholar
    • Export Citation
  • 35

    Peel MC, Finlayson BL, McMahon TA: Updated world map of the Köppen-Geiger climate classification. Hydrol Earth Syst Sci 11:16331644, 2007

    • Search Google Scholar
    • Export Citation
  • 36

    Qureshi AI, Suri MF, Yahia AM, Suarez JI, Guterman LR, Hopkins LN, : Risk factors for subarachnoid hemorrhage. Neurosurgery 49:607613, 2001

    • Search Google Scholar
    • Export Citation
  • 37

    Rose G: Seasonal variation in blood pressure in man. Nature 189:235, 1961

  • 38

    Shinkawa A, Ueda K, Hasuo Y, Kiyohara Y, Fujishima M: Seasonal variation in stroke incidence in Hisayama, Japan. Stroke 21:12621267, 1990

    • Search Google Scholar
    • Export Citation
  • 39

    Suarez JI, Tarr RW, Selman WR: Aneurysmal subarachnoid hemorrhage. N Engl J Med 354:387396, 2006

  • 40

    Sudlow CL, Warlow CP: Comparing stroke incidence worldwide: what makes studies comparable? Stroke 27:550558, 1996

  • 41

    Tan CL, Cooke EK, Leib DE, Lin YC, Daly GE, Zimmerman CA, : Warm-sensitive neurons that control body temperature. Cell 167:4759, 59.e1–59.e15, 2016

    • Search Google Scholar
    • Export Citation
  • 42

    Teunissen LL, Rinkel GJ, Algra A, van Gijn J: Risk factors for subarachnoid hemorrhage: a systematic review. Stroke 27:544549, 1996

  • 43

    Turin TC, Kita Y, Murakami Y, Rumana N, Sugihara H, Morita Y, : Increase of stroke incidence after weekend regardless of traditional risk factors: Takashima Stroke Registry, Japan; 1988–2003. Cerebrovasc Dis 24:328337, 2007

    • Search Google Scholar
    • Export Citation
  • 44

    van Gijn J, Rinkel GJ: Subarachnoid haemorrhage: diagnosis, causes and management. Brain 124:249278, 2001

  • 45

    Vlak MH, Rinkel GJ, Greebe P, van der Bom JG, Algra A: Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case-crossover study. Stroke 42:18781882, 2011

    • Search Google Scholar
    • Export Citation
  • 46

    von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:14531457, 2007

    • Search Google Scholar
    • Export Citation
  • 47

    White WB: Cardiovascular risk and therapeutic intervention for the early morning surge in blood pressure and heart rate. Blood Press Monit 6:6372, 2001

    • Search Google Scholar
    • Export Citation

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