Temperature effects on incidence of surgery for acute type A aortic dissection in the Nordics

ABSTRACT

We aimed to investigate a hypothesised association between daily mean temperature and the risk of surgery for acute type A aortic dissection (ATAAD). For the period of 1 January 2005 until 31 December 2019, we collected daily data on mean temperatures and date of 2995 operations for ATAAD at 10 Nordic cities included in the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) collaboration. Using a two-stage time-series approach, we investigated the association between hot and cold temperatures relative to the optimal temperature and the rate of ATAAD repair in the selected cities. The relative risks (RRs) of cold temperatures (≤−5°C) and hot temperatures (≥21°C) compared to optimal temperature were 1.47 (95% CI: 0.72–2.99) and 1.43 (95% CI: 0.67–3.08), respectively. In line with previous studies, we observed increased risk at cold and hot temperatures. However, the observed associations were not statistically significant, thus only providing weak evidence of an association.

KEYWORDS:

• Heat
• cold
• temperature
• acute type A aortic dissection
• muli-centre study

Responsible Editor

Jennifer Stewart Williams

Responsible Editor

Jennifer Stewart Williams

Author contributions

“D.O.Å., H.B. and I.Z. contributed to conceptualization; D.O.Å., H.B., A.O. and I.Z. contributed to methodology; D.O.Å. and A.O. contributed to formal analysis; I.Z. contributed to resources; I.Z., T.G., A.G. and D.O.Å. contributed to data curation; D.O.Å. contributed to writing—original draft preparation; D.O.Å., H.B., A.O., S.N., K.A., M.T., M.B., E.C.H., A.J., C.J.H.M., M.J., T.J., A.M., P.S.O., C.O., A.A., E.P., P.R., A.W., J.S., A.G., T.G. and I.Z. contributed to data collection, writing—review and editing; D.O.Å. contributed to visualization; I.Z. contributed to funding acquisition.

All authors have read and agreed to the published version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics and consent

Ethical approval was obtained by each participating centre from Finland and Iceland, whereas national approval was granted for the Swedish (EPN 2019-02097) and Danish centres (STPS 31-1521-67).

Paper context

There is suggestive evidence of the impacts of high and low temperatures on mortality and morbidity; however less is known about the impact on the risk of surgery for acute type A aortic dissection. Applying time series regression for ten cities in the Nordics and pooling the results with a meta-analytic approach, we observed weak evidence of higher risk of surgery at high and low temperatures, however, not to a statistically significant extent.

Additional information

Funding

This research was funded by The Agreement for Medical Education and Research, Sweden