Abstract
Data on seasonal differences in stroke incidence are conflicting. Little is known about seasonal variability in etiological stroke subtypes and population-based data on possible trigger factors are lacking. The Ludwigshafen Stroke Study is a prospective population-based stroke registry. All residents of the city of Ludwigshafen who suffer from acute stroke or TIA are registered. Patients with first-ever stroke (FES) were included for the present analysis. Between January 1, 2006 and December 31st, 2010, 1,779 patients (age 71.7 ± 13.4 years (mean + standard deviation; 897 (50.4 %) women) suffered a FES. Incidence for FES was lowest in summer (reference) with significantly higher rates in winter (rate ratio (RR) 1.20, 95 % confidence interval (CI) 1.05–1.37) and spring (RR 1.21 95 % CI 1.06–1.38). First-ever ischemic stroke (FEIS) was more common in winter (RR 1.16, 95 %CI 1.01–1.34) and first-ever intracerebral haemorrhage (FE-ICH) was more frequent in spring (RR 2.0, 95 %CI 1.24–3.22) than in summer. In FES, systolic and diastolic blood pressure on admission (SBP/DBP) showed significant variation with lowest values in summer (SBP: p = 0.02; DBP p = 0.05). In subtypes of FEIS, cardioembolism tended to be more common in winter (p = 0.14). There were no differences in risk factor prevalence between seasons. Leukocyte count on admission was lowest in summer (8.2 ± 1.4/μl) and highest in winter (8.9 ± 1.9/μl; p = 0.008). The hematocrit showed a similar trend (p = 0.06). Our data show higher incidence rates for FES in winter and spring, for FEIS in winter and for FE-ICH in spring. Variations in blood pressure on admission and leukocyte counts were associated with these findings and may possibly contribute to seasonal stroke variability.
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Data analysis was supported by a grant from the Deutsche Forschungsgemeinschaft (DFG; GR1102/6-1). LuSSt is part of the German Competence Network Stroke.
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Palm, F., Santos, M.D., Urbanek, C. et al. Stroke seasonality associations with subtype, etiology and laboratory results in the Ludwigshafen Stroke Study (LuSSt). Eur J Epidemiol 28, 373–381 (2013). https://doi.org/10.1007/s10654-013-9772-4
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DOI: https://doi.org/10.1007/s10654-013-9772-4