title: Effects of ambient temperature on stroke hospital admissions: Results from a time-series analysis of 104,432 strokes in Guangzhou, China.
abstract: Stroke is a main cause of death and public health burden in China. The evidence on the burden of different strokes attack attribute to ambient temperature in China is limited. This study aimed to show the characteristics of stroke attack and the attributable risk due to temperature based on hospital admission data in Guangzhou, one of the most developed cities in China.
  
  
  
  From January 1, 2013 to December 31, 2015, 104,432 stroke hospitalizations in Guangzhou residents from 67 hospitals for stroke sentinel surveillance were registered. Characteristics of hospital admissions by gender, age group, calendar year and stroke subtype were analyzed, and distributed lag non-linear models were applied to evaluate the effects of temperature on stroke attack admissions.
  
  
  
  Stroke attack admissions increased from 31,851 to 36,755 through 2013 to 2015, increasing by 15.4%. An increasing trend in the risk of stroke attack with age was observed, irrespectively of stroke subtype and calendar year. People with hypertension were more likely to have an associated stroke than people without that. The effects of cold temperature on attack admissions for CBI and ICH strokes were significant. Overall, the percentages of CBI and ICH attack admissions attribute to cold temperature were 9.06% (95% CI: 1.84, 15.00) and 15.09% (95% CI: 5.86, 21.96), respectively. Besides, elderly people were more vulnerable to cold temperature than the young.
  
  
  
  Measures should be taken to increase public awareness about the ill effects of cold temperature on stroke attack, and educate the public about self-protection.
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
authors.forename: Pi
authors.initials: P
authors.lastname: Guo
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
authors.forename: Murui
authors.initials: M
authors.lastname: Zheng
authors.forename: Yulin
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
authors.forename: Wenru
authors.initials: W
authors.lastname: Feng
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
authors.forename: Jiagang
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
authors.forename: Changyu
authors.initials: C
authors.lastname: Deng
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
authors.forename: Ganfeng
authors.initials: G
authors.lastname: Luo
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
authors.forename: Bingying
authors.initials: B
authors.lastname: Pan
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China. Electronic address: StrokeStudyGZ@yahoo.com.
authors.forename: Huazhang
authors.initials: H
authors.lastname: Liu
mesh_terms: D002681:China / Q000453:epidemiology; D002947:Cities; D003080:Cold Temperature; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D018571:Sentinel Surveillance; D020521:Stroke / Q000453:epidemiology*
keywords: Attack rate; Attributable risk; Distributed lag effect; Hospital admission; Stroke; Temperature