Association of Ambient Particulate Matter Pollution of Different Sizes With In-Hospital Case Fatality Among Stroke Patients in China

医学 优势比 气动直径 病死率 冲程(发动机) 逻辑回归 微粒 人口学 环境卫生 内科学 人口 生态学 机械工程 生物 工程类 社会学
作者
Miao Cai,Shiyu Zhang,Xiaojun Lin,Zhengmin Qian,Stephen Edward McMillin,Yin Yang,Zilong Zhang,Jay Pan,Hualiang Lin
出处
期刊:Neurology [Lippincott Williams & Wilkins]
卷期号:98 (24) 被引量:48
标识
DOI:10.1212/wnl.0000000000200546
摘要

To characterize the association of ambient particulate matter (PM) pollution of different sizes (PM ≤1 µm in aerodynamic diameter [PM1], PM2.5, and PM10) with in-hospital case fatality among patients with stroke in China.We collected hospitalizations due to stroke in 4 provinces in China from 2013 to 2019. Seven-day and annual averages of PM prior to hospitalization were estimated using bilinear interpolation and residential addresses. Associations with in-hospital case fatality were estimated using random-effects logistic regression models. Potential reducible fraction and the number of fatalities attributed to PM were estimated using a counterfactual approach.Among 3,109,634 stroke hospitalizations (mean age 67.23 years [SD 12.22]; 1,765,644 [56.78%] male), we identified 32,140 in-hospital stroke fatalities (case fatality rate 1.03%). Each 10 µg/m3 increase in 7-day average (short-term) exposure to PM was associated with increased in-hospital case fatality: odds ratios (ORs) were 1.058 (95% CI 1.047-1.068) for PM1, 1.037 (95% CI 1.031-1.043) for PM2.5, and 1.025 (95% CI 1.021-1.029) for PM10. Similar but larger ORs were observed for annual averages (long-term): 1.240 (95% CI 1.217-1.265) for PM1, 1.105 (95% CI 1.094-1.116) for PM2.5, and 1.090 (95% CI 1.082-1.099) for PM10. In counterfactual analyses, PM10 was associated with the largest potential reducible fraction in in-hospital case fatality (10% [95% CI 8.3-11.7] for short-term exposure and 21.1% [19.1%-23%] for long-term exposure), followed by PM1 and PM2.5.PM pollution is a risk factor for in-hospital stroke-related deaths. Strategies that target reducing PM pollution may improve the health outcomes of patients with stroke.
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