国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Long-Term Exposure to Air Pollution and Survival After Ischemic Stroke The China National Stroke Registry Cohort

第一作者：Gongbo Chen,Anxin Wang

通讯作者：Yongjun Wang,Yuming Guo

air pollution machine learning nitrogen dioxide pa

基本信息

2019-02-11

已发表文章

发表杂志：Stroke

发表类型: Original Contributions

影响因子(IF): 7.914

PMID: 30741622 Pubmed原文链接 全文下载

主要研究背景及目的

China bears a heavy burden of stroke because of its large population of elderly people and the propensity for stroke. Previous studies have examined the association between air pollution and stroke mortality or hospital admission. However, the global evidence for adverse effects of air pollution on survival after stroke is scarce.

方法

We used the first national hospital-based prospective registry cohort of stroke in China, which included 12291 ischemic stroke patients who visited hospitals during 2007 to 2008. All patients were followed for 1-year poststroke. Deaths during the follow-up period were recorded. Participants’ 3-year prestroke exposures to ambient PM1, PM2.5, PM10 (particulate matter with aerodynamic diameters ≤1, ≤2.5, and ≤10 μm, respectively) and NO2 (nitrogen dioxide) were estimated by machine learning algorithms with satellite remote sensing, land use information, and meteorological data. Cox proportional hazards models were used to examine the association between air pollution and survival after ischemic stroke.

结论

Prestroke exposure to PM1 and PM2.5 was associated with increased incident fatal ischemic stroke in the year following an ischemic stroke in China. Improved air quality may be beneficial for people to recover from stroke.

主要结果

In total, 1649 deaths were identified during the 1-year follow-up period. After controlling for potential confounders, significant associations were observed between exposure to PM1 and PM2.5 and incident fatal ischemic stroke. The corresponding hazard ratios and 95% CIs associated with 10 μg/m3 increase in PM1 and PM2.5 were 1.05 (1.02–1.09) and 1.03 (1.00–1.06), respectively. No significant association was observed for PM10 or NO2 (hazard ratios and 95% CIs, 1.01 [1.00–1.03] and 1.03 [0.99–1.06], respectively). Higher hazard ratios (and 95% CIs) were observed for male, elderly and obese individuals.