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Extreme temperature increases the severity of intracerebral hemorrhage: An analysis based on the cold region of China
Xun Xu, Chunyang Liu, Rui Liu, Qiuyi Jiang, Enzhou Lu, Chao Yuan, Yanchao Liang, Huan Xiang, Boxian Zhao, Xin Chen, Ailing Lian, Qi Zhou, Guang Yang
2022, 2(3): 178-185. doi: 10.2478/fzm-2022-0024
Keywords: ambient temperature, intracerebral hemorrhage, hematoma volume, midline shift
  Objective  The purpose of this study was to find a suitable model to evaluate the relationship between temperature and intracerebral hemorrhage (ICH) and explore the effects of cold spells and heat waves on the clinicopathological parameters of ICH patients.  Methods  We conducted a retrospective study based on the ICH admission in the First Affiliated Hospital of Harbin Medical University from 2015 to 2020 (N = 11 124). The relationship between different seasons and the number of patients with ICH was explored. Poisson Akaike information criterion (AIC) was used to select the optimal model for temperature and ICH. Binary logistic regression analysis was used to investigate the association between extreme temperatures and clinicopathological features.  Results  Hospital admissions for patients with ICH showed monthly changes. The optimal cold spell was defined as the daily average temperature < 3rd percentile, lasting for five days, while the optimal heat wave was defined as the daily average temperature > 97th percentile, lasting for three days. Based on the generalized extreme weather model, cold climate significantly increased the risk of hematoma volume expansion (OR 1.003; 95% CI: 1.000-1.005, P = 0.047). In the optimal model, the occurrence of cold spells and heat waves increased the risk of midline shift in both conditions (OR 1.067; 95% CI: 1.021-1.115, P = 0.004; OR 1.077; 95% CI: 1.030-1.127, P = 0.001).  Conclusion  Our study shows that seasonal cold spells and heat waves are essential factors affecting ICH severity, and targeted preventive measures should be taken to minimize the pathological impacts.