2014-2020年上海市极端气温与脑血管病死亡的关联OA

Objective To explore the association between extreme temperatures and cerebrovascular disease mortality among residents in Shanghai,and to investigate the lag effects of temperature on cerebrovascular disease deaths. Methods Data for this study were obtained from the death registration information system of the Shanghai Municipal Center for Disease Control & Prevention.Daily mortality data on cerebrovascular disease(including three subtypes:hemorrhagic stroke,cerebral infarction,and sequelae of cerebrovascular disease)among residents in Shanghai from January 1,2014 to December 31,2020 were collected,with causes of death coded and determined based on the underlying cause of death.A distributed lag non-linear model was used to quantitatively estimate the association between exposure to extreme temperatures and the mortality risk of cerebrovascular disease within a lag period of 0 to 21 days.Extreme low temperature and extreme high temperature were defined as below the 2.5th percentile and above the 97.5th percentile of daily mean temperature during the study period,respectively.Stratified analyses were conducted by cerebrovascular disease subtype,gender,age,and education level to explore the heterogeneity of the association across different populations. Results A total of 162 928 cerebrovascular disease deaths were included in this study.The exposure-response curves for the RR of death from overall cerebrovascular disease,cerebral infarction,and sequelae of cerebrovascular disease in relation to daily mean temperature exhibited an inverted J-shape,with the minimum mortality temperature ranging from 22.7 ℃ to 27.9 ℃.The mortality risk of cerebrovascular disease associated with extreme low temperature was higher among patients aged 0-64 years than those aged ≥65 years[RR 2.35(95％CI 1.50-3.68)vs.RR 1.86(95％CI 1.60-2.16),P=0.01],and higher for patients with cerebral infarction and sequelae of cerebrovascular disease than for those with hemorrhagic stroke.The overall mortality risk of cerebrovascular disease associated with extreme high temperature peaked on the first day after exposure(RR 1.09,95％CI 1.05-1.13)and persisted until the seventh day.The mortality risk for sequelae of cerebrovascular disease was the highest at a lag of seven days(RR 1.22,95％CI 1.15-1.30). Conclusions Exposure to extreme temperatures is significantly associated with an increased risk of cerebrovascular disease mortality in Shanghai,and the association shows heterogeneity across different populations and cerebrovascular disease subtypes.