ArticleStroke2024
Extreme Temperatures and Stroke Mortality: Evidence From a Multi-Country Analysis.
Article in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Building the model: a review of input structures in extreme temperature-health.Environmental health : a global access science source · 2026Pooled it
- Non optimal temperatures and chronic cardiovascular diseases.Seminars in immunopathology · 2026Review
- Extreme Temperatures, Elevated PM2.5, and Acute Care Events Among Dual-Eligible Nursing Facility Residents.Journal of the American Geriatrics Society · 2026Article
- Impact of Climate Warming on All-Causes Mortality in China: The Role of Non-Optimal Temperature Exposure and Multi-Scenario Projections to 2050.GeoHealth · 2026Article
- Stroke and climate change: A World Stroke Organization scientific statement.International journal of stroke : official journal of the International Stroke Society · 2026Review
- Stroke Care and Outcomes Among Patients Experiencing Homelessness: A Systematic Review and Meta-Analysis.Neurology open access · 2026Article
- Prevention in stroke - Current state, present gaps and probable next steps.Neurological research and practice · 2026Review
- Association Between Living Environmental Factors and Stroke in Middle-Aged and Older Chinese Adults: A Nationwide Prospective Cohort Study.Journal of the American Heart Association · 2026Article
- Evaluation of heat warning thresholds with multiple lagged and cumulative health impacts based on a 20-year population database.Scientific reports · 2026Article
- Extreme temperature and humidity exposure elevates acute intracerebral hemorrhage risk.iScience · 2026Article
- Spatiotemporal patterns of excess mortality attributable to prolonged cold spells in China, 2020-2023.BMC public health · 2026Article
- Temperature- and humidity-modified associations between ambient air pollution and syncope outpatient visits: a time series analysis in Beijing, China.Scientific reports · 2026Article
- Forecasting tool of hospital demand during heat periods: a time-series regression study in Bern, Switzerland.BMJ public health · 2026Article
- The neuropsychiatric toll of rising temperatures on women's health in low-income and middle-income countries: a scoping review.BMJ global health · 2025Article
- Article
- Extreme Heat and Arrhythmia in Patients With Implanted Devices.Journal of the American Heart Association · 2025Article
- Temperature Exposure and Acute Cardiovascular Disease Risk in New York City: Case Time Series.Journal of the American Heart Association · 2025Article
- Exploring the influence of moon phases and weather on mortality in a palliative care unit over a ten year period.Scientific reports · 2025Article
- Machine learning-based forecasting of daily acute ischemic stroke admissions using weather data.NPJ digital medicine · 2025Article
- Environmental determinants of cerebral haemorrhage in older adults: behavioural pathways and population health implications.Frontiers in public health · 2025Review
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
backgroundExtreme temperatures contribute significantly to global mortality. While previous studies on temperature and stroke-specific outcomes presented conflicting results, these studies were predominantly limited to single-city or single-country analyses. Their findings are difficult to synthesize due to variations in methodologies and exposure definitions.
methodsWithin the Multi-Country Multi-City Network, we built a new mortality database for ischemic and hemorrhagic stroke. Applying a unified analysis protocol, we conducted a multinational case-crossover study on the relationship between extreme temperatures and stroke. In the first stage, we fitted a conditional quasi-Poisson regression for daily mortality counts with distributed lag nonlinear models for temperature exposure separately for each city. In the second stage, the cumulative risk from each city was pooled using mixed-effect meta-analyses, accounting for clustering of cities with similar features. We compared temperature-stroke associations across country-level gross domestic product per capita. We computed excess deaths in each city that are attributable to the 2.5% hottest and coldest of days based on each city's temperature distribution.
resultsWe collected data for a total of 3 443 969 ischemic strokes and 2 454 267 hemorrhagic stroke deaths from 522 cities in 25 countries. For every 1000 ischemic stroke deaths, we found that extreme cold and hot days contributed 9.1 (95% empirical CI, 8.6-9.4) and 2.2 (95% empirical CI, 1.9-2.4) excess deaths, respectively. For every 1000 hemorrhagic stroke deaths, extreme cold and hot days contributed 11.2 (95% empirical CI, 10.9-11.4) and 0.7 (95% empirical CI, 0.5-0.8) excess deaths, respectively. We found that countries with low gross domestic product per capita were at higher risk of heat-related hemorrhagic stroke mortality than countries with high gross domestic product per capita (
conclusionsBoth extreme cold and hot temperatures are associated with an increased risk of dying from ischemic and hemorrhagic strokes. As climate change continues to exacerbate these extreme temperatures, interventional strategies are needed to mitigate impacts on stroke mortality, particularly in low-income countries.
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