Skip to main content
Log in

The association between weather conditions and stroke admissions in Turkey

  • Original Paper
  • Published:
International Journal of Biometeorology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Anlar O, Tombul T, Unal O, Kayan M (2002) Seasonal and environmental temperature variation in the occurrence of ischemic strokes and intracerebral hemorrhages in a Turkish adult population. Int J Neurosci 112:959–963

    Article  Google Scholar 

  • Beseoglu K, Hänggi D, Stummer W, Steiger HJ (2008) Dependence of subarachnoid hemorrhage on climate conditions: a systematic meteorological analysis from the Düsseldorf metropolitan area. Neurosurgery 62:1033–1038

    Article  Google Scholar 

  • Cowperthwaite MC, Burnett MG (2011) An analysis of admissions from 155 United States hospitals to determine the influence of weather on stroke incidence. J Clin Neurosci 18:618–623

    Article  Google Scholar 

  • Ebi KL, Exuzides KA, Lau E, Kelsh M, Barnston A (2004) Weather changes associated with hospitalizations for cardiovascular diseases and stroke in California, 1983–1998. Int J Biometeorol 49:48–58

    Article  CAS  Google Scholar 

  • Feigin VL, Nikitin YP, Bots ML, Vinogradova TE, Grobbee DE (2000) A population-based study of the associations of stroke occurrence with weather parameters in Siberia, Russia (1982–92). Eur J Neurol 7:171–178

    Article  CAS  Google Scholar 

  • Goggins WB, Woo J, Ho S, Chan EY, Chau PH (2012) Weather, season, and daily stroke admissions in Hong Kong. Int J Biometeorol 56:865–872

    Article  Google Scholar 

  • Hakan T, Kizilkilic O, Adaletli I, Karabagli H, Kocer N, Islak C (2003) Is there any seasonal influence in spontaneous bleeding of intracranial aneurysm and and/or AVM in Istanbul? Swiss Med Wkly 133:267–272

    Google Scholar 

  • Hong YC, Rha JH, Lee JT, Ha EH, Kwon HJ, Kim H (2003) Ischemic stroke associated with decrease in temperature. Epidemiology 14:473–478

    Google Scholar 

  • Hori A, Hashizume M, Tsuda Y, Tsukahara T, Nomiyama T (2012) Effects of weather variability and air pollutants on emergency admissions for cardiovascular and cerebrovascular diseases. Int J Environ Health Res 22:416–430

    Article  CAS  Google Scholar 

  • IPCC (2007) Summary for policymakers (2007). In: Parry ML, Canziani OF, Palutikof JP, van der Linden PJ, Hanson CE (eds) Climate change 2007: impacts, adaptation and vulnerability. Contribution of working group II to the fourth assessment report of the Intergovernmental Panel on Climate Change. Cambridge University Press, Cambridge, pp 7–22

    Google Scholar 

  • Jimenez-Conde J, Ois A, Gomis M, Rodriguez-Campello A, Cuadrado-Godia E, Subirana I (2008) Weather as a trigger of stroke. Daily meteorological factors and incidence of stroke subtypes. Cerebrovasc Dis 26:348–354

    Article  CAS  Google Scholar 

  • Keatinge WR, Coleshaw SR, Cotter F, Mattock M, Murphy M, Chelliah R (1984) Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling: factors in mortality from coronary and cerebral thrombosis in winter. Br Med J (Clin Res Ed) 289:1405–1408

    Article  CAS  Google Scholar 

  • Kyobutungi C, Grau A, Stieglbauer G, Becher H (2005) Absolute temperature, temperature changes and stroke risk: a case-crossover study. Eur J Epidemiol 20:693–698

    Article  CAS  Google Scholar 

  • Lejeune JP, Vinchon M, Amouyel P, Escartin T, Escartin D, Christiaens JL (1994) Association of occurrence of aneurysmal bleeding with meteorologic variations in the north of France. Stroke 25:338–341

    Article  CAS  Google Scholar 

  • Matsumoto M, Ishikawa S, Kajii E (2010) Cumulative effects of weather on stroke incidence: a multi-community cohort study in Japan. J Epidemiol 20:136–142

    Article  Google Scholar 

  • McArthur K, Dawson J, Walters M (2010) What is it with the weather and stroke? Expert Rev Neurother 10:243–249

    Article  Google Scholar 

  • Neild PJ, Syndercombe-Court D, Keatinge WR, Donaldson GC, Mattock M, Caunce M (1994) Cold-induced increases in erythrocyte count, plasma cholesterol and plasma fibrinogen of elderly people without a comparable rise in protein C or factor X. Clin Sci (Lond) 86:43–48

    CAS  Google Scholar 

  • Pinkerton KE, Rom WN, Akpinar-Elci M, Balmes JR, Bayram H, Brandli O, Hollingsworth JW, Kinney PL, Margolis HG, Martin WJ, Sasser EN, Smith KR and Takaro TK (2012) on behalf of the American Thoracic Society Environmental Health Policy 9:3-8

  • Pinkerton KE, Rom WN, Carlsten C, Jaakkola JK, Bayram H, Sigsgaard T, Elci MA, Costa DL (2013) Climate change and global public health. Turk Toraks Derg 14:115–122

    Article  Google Scholar 

  • Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB et al (2012) Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation 125:e2–e220

    Article  Google Scholar 

  • Rothwell PM, Wroe SJ, Slattery J, Warlow CP (1996) Is stroke incidence related to season or temperature? Lancet 347:934–936

    Article  CAS  Google Scholar 

  • Vuleković P, Nikolić-Đorić E, Kojadinović Z, Papić V, Karan M, Dóczi T (2011) A temporal pattern in the occurrence of aneurysmal subarachnoid hemorrhage in the Province of Vojvodina, Serbia. Acta Neurochir (Wien) 153:1313–1319

    Article  Google Scholar 

Download references

Conflict of interest

The authors have no commercial associations or sources of support that might pose a conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nurettin Özgür Doğan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Çevik, Y., Doğan, N.Ö., Daş, M. et al. The association between weather conditions and stroke admissions in Turkey. Int J Biometeorol 59, 899–905 (2015). https://doi.org/10.1007/s00484-014-0890-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00484-014-0890-9

Keywords

Navigation