Effect of short-term environmental ozone exposure on hospitalization of ischemic stroke:a time series analysis of Wuhan, China / 国际脑血管病杂志

ABSTRACT

Objective To investigate the effect of short-term environmental ozone (O3) exposure on hospitalization risk of acute ischemic stroke (AIS) and its subtypes.Methods From January 1,2016 to December 31,2017,the hospitalization data of patients with AIS from Zhongnan Hospital of Wuhan University,air pollutant data published by China Air Quality Online Monitoring and Analysis Plafform,and the meteorological data published by China Meteorological Data Network were collectcd.According to TOAST etiological classification criteria,the patients with AIS were divided into large-artery atherosclerosis (LAA),small-artery occlusion (SVO),cardioembolism (CE),and stroke of other etiology (SOE).The effect of short-term O3 exposure on the hospitalization risk of AIS and its subtypes was analyzed retrospectively using a distributed lag non-linear model of time series analysis.Results A total of 1 413 patients with AIS were enrolled,including 910 males (64.4％),aged 67.7± 12.8 years (range,18-99 years).Short-term O3 exposure increased the overall hospitalization risk of AIS [relative risk (RR) 1.06,95％ confidence interval (CI) 0.99-1.13],mainly caused by increased hospitalization risks of LAA (RR 1.17,95％ CI 1.02-1.34;lag 5 d) and SVO (RR 1.24,95％ CI 1.06-1.45;lag 3 d).After introducing double pollutant (O3 + other pollutants) model its RR did not have significant changes.A stratified analysis based on demographic characteristics and vascular risk factors showed that the different populations had different sensitivities to the acute hazard effects of O3.Conclusion Short-term exposure to O3 could significantly increase the hospitalization risks of LAA and SVO.