Extreme temperature increases the severity of intracerebral hemorrhage: An analysis based on the cold region of China

Objective:The purpose of this study was to find a suitable model to evaluate the relationship between temperature and intracerebral hemorrhage(ICH)and explore the effects of cold spells and heat waves on the clinicopathological parameters of ICH patients.Methods:We conducted a retrospective study based on the ICH admission in the First Affiliated Hospital of Harbin Medical University from 2015 to 2020(N=11124).The relationship between different seasons and the number of patients with ICH was explored.Poisson Akaike information criterion(AIC)was used to select the optimal model for temperature and ICH.Binary logistic regression analysis was used to investigate the association between extreme temperatures and clinicopathological features.Results:Hospital admissions for patients with ICH showed monthly changes.The optimal cold spell was defined as the daily average temperature<3rd percentile,lasting for five days,while the optimal heat wave was defined as the daily average temperature>97th percentile,lasting for three days.Based on the generalized extreme weather model,cold climate significantly increased the risk of hematoma volume expansion(OR 1.003;95%CI:1.000-1.005,P=0.047).In the optimal model,the occurrence of cold spells and heat waves increased the risk of midline shift in both conditions(OR 1.067;95%CI:1.021-1.115,P=0.004;OR 1.077;95%CI:1.030-1.127,P=0.001).Conclusion:Our study shows that seasonal cold spells and heat waves are essential factors affecting ICH severity,and targeted preventive measures should be taken to minimize the pathological impacts.

The predictive role of the neutrophil-lymphocyte ratio in the prognosis of adult patients with stroke

Our study aimed to determine the effect of the neutrophil-lymphocyte ratio on the prognosis of adult patients with acute stroke.We searched the Web of Science,PubMed,Embase,Cochrane Library,and China National Knowledge Infrastructure databases and selected all of the potentially eligible studies.From the included studies,we extracted characteristics such as the stroke type and acquisition time until routine blood collection and the odds ratios across studies.The 95%confidence intervals and odds ratios were pooled to calculate the effect size for the neutrophil-lymphocyte ratio in acute stroke patients.We defined poor function outcomes according to the modified Rankin Scale≥3 or Glasgow Outcome Scale<3.Thirteen studies with 4443 patients were included in our analysis,including 7 ischemic and 6 hemorrhagic stroke studies.The pooled odds ratios for poor functional outcome at 3 months with a higher neutrophil-lymphocyte ratio in acute ischemic and hemorrhagic patients were 1.689(95%CI=1.184-2.409,p<0.001)and 1.125(95%CI=1.022-1.239,p<0.001),respectively,and the overall pooled odds ratio for poor functional outcome following stroke was 1.257(95%CI=1.146-1.379,p<0.001).At the same time,the overall combined odds ratio for death at 3 months was 1.632(95%CI=1.155-2.306,p<0.001).The neutrophil-lymphocyte ratio,an easily calculated marker,plays a predictive role in the short-term outcomes of adult patients(mean age≥50 years)following acute ischemic and hemorrhagic stroke.