title: The association between weather conditions and stroke admissions in Turkey.
abstract: Although several factors such as cigarette smoking, blood pressure, diabetes, obesity, hypercholesterolemia, physical inactivity and dietary factors have been well documented to increase the risk for stroke, there are conflicting data about the role of meteorological variables in the etiology of stroke. We conducted a retrospective study to investigate the association between weather patterns, including daily temperature, humidity, wind speed, and air pressure, and stroke admissions to the Emergency Department of Atatürk Training and Research Hospital in Ankara, Turkey, between January 2009 and April 2010. Generalized additive models with logistic link function were used to investigate the relationship between predictors and days with and without stroke admission at lags 0-4. A total of 373 stroke patients were admitted to the emergency department (ED) between January 2009 and April 2010. Of patients, 297 had ischemic stroke (IS), 34 hemorrhagic stroke (HS), and 42 subarachnoidal hemorrhage (SAH). Although we did not find any association between overall admissions due to stroke and meteorological parameters, univariable analysis indicated that there were significantly more SAH cases on days with lower daily mean temperatures of 8.79 ± 8.75 °C as compared to relatively mild days with higher temperatures (mean temperature = 11.89 ± 7.94 °C, p = 0.021). The multivariable analysis demonstrated that admissions due to SAH increased on days with lower daily mean temperatures for the same day (lag 0; odds ratio (OR) [95% confidence interval (95% CI)] = 0.93 [0.89-0.98], p = 0.004) and lag 1 (OR [95% CI] =0.76 [0.67-0.86], p = 0.001). Furthermore, the wind speed at both lag 1 (OR [95% CI] = 1.63 [1.27-2.09], p = 0.001) and lag 3 (OR [95% CI] = 1.43 [1.12-1.81], p = 0.004) increased admissions due to HS, respectively. In conclusion, our study demonstrated that there was an association between ED admissions due to SAH and HS and weather conditions suggesting that meteorological variables may, at least in part, play as risk factors for intracranial hemorrhages.
authors.affiliation: Department of Emergency Medicine, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Yunsur
authors.initials: Y
authors.lastname: Çevik
authors.forename: Nurettin Özgür
authors.initials: NÖ
authors.lastname: Doğan
authors.forename: Murat
authors.initials: M
authors.lastname: Daş
authors.forename: Asliddin
authors.initials: A
authors.lastname: Ahmedali
authors.forename: Seval
authors.initials: S
authors.lastname: Kul
authors.forename: Hasan
authors.initials: H
authors.lastname: Bayram
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002947:Cities / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020521:Stroke / Q000453:epidemiology*; D014421:Turkey / Q000453:epidemiology; D014887:Weather