ArticleThe Lancet regional health. Western Pacific2022
Low temperature and temperature decline increase acute aortic dissection risk and burden: A nationwide case crossover analysis at hourly level among 40,270 patients.
Article in The Lancet regional health. Western Pacific, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Cold exposure increases aortic dissection risk through extracellular cold inducible RNA binding protein and toll like receptor 4 signaling.Scientific reports · 2026Article
- Low ambient temperature and sudden temperature drop increases the incidence of acute aortic dissection: a retrospective analysis from the northeast region of China.Frontiers in public health · 2026Article
- Spatiotemporal Mortality Patterns and Temperature-Associated Risk of Aortic Dissection in the United States: A National CDC WONDER Database Analysis.Vascular health and risk management · 2026Article
- Ambient Cold and Mortality in Pan-Arterial Diseases: A Nationwide Ecological Analysis of CDC WONDER Data.Vascular health and risk management · 2026Article
- The Relationships of Air Pollution and Meteorological Factors with Acute Aortic Dissection in Urumqi, China: A Distributed Lag Nonlinear Model Analysis.Journal of multidisciplinary healthcare · 2025Article
- Hourly air pollution exposure and the onset of symptomatic arrhythmia: an individual-level case-crossover study in 322 Chinese cities.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- Risk assessment and disease burden of extreme precipitation on hospitalizations for acute aortic dissection in a subtropical coastal Chinese city.Frontiers in public health · 2023Article
- Effect of temperature changes between neighboring days on acute aortic dissection in non-heating periods.The Lancet regional health. Western Pacific · 2023Article
- Author response: Effect of temperature changes between neighboring days on acute aortic dissection in non-heating periods.The Lancet regional health. Western Pacific · 2023Article
- Short-term effects of air pollution and weather changes on the occurrence of acute aortic dissection in a cold region.Frontiers in public health · 2023Article
- Impact of climate change on surgery: A scoping review to define existing knowledge and identify gaps.The journal of climate change and healthArticle
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24 authors.
Funding
Abstract
Background: Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency with high mortality, so identifying modifiable risk factors of AAD is of great public health significance. The associations of non-optimal temperature and temperature variability with AAD onset and the disease burden have not been fully understood. Methods: We conducted a time-stratified case-crossover study using a nationwide registry dataset from 1,868 hospitals in 313 Chinese cities. Conditional logistic regression and distributed lag models were used to investigate associations of temperature and temperature changes between neighboring days (TCN) with the hourly AAD onset and calculate the attributable fractions. We also evaluated the heterogeneity of the associations. Findings: A total of 40,270 eligible AAD cases were included. The exposure-response curves for temperature and TCN with AAD onset risk were both inverse and approximately linear. The risks were present on the concurrent hour (for temperature) or day (for TCN) and lasted for almost 1 day. The cumulative relative risks of AAD were 1.027 and 1.026 per 1°C lower temperature and temperature decline between neighboring days, respectively. The associations were significant during the non-heating period, but were not present during the heating period in cities with central heating. 23.13% of AAD cases nationwide were attributable to low temperature and 1.58% were attributable to temperature decline from the previous day. Interpretation: This is the largest nationwide study demonstrating robust associations of low temperature and temperature decline with AAD onset. We, for the first time, calculated the corresponding disease burden and further showed that central heating may be a modifier for temperature-related AAD risk and burden. Funding: This work was supported by the National Natural Science Foundation of China (92043301 and 92143301), Shanghai International Science and Technology Partnership Project (No. 21230780200), the Medical Research Council-UK (MR/R013349/1), and the Natural Environment Research Council UK (NE/R009384/1).
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