Relationship between Supra-Annual Trends in Influenza Rates and Stroke Occurrence

Field, Thalia S.; Zhu, Hongmei; Tarrant, Marie; Mitchell, T. J. Ross; Hill, Michael D.

doi:10.1159/000079948

Cited by 19 publications

(8 citation statements)

References 21 publications

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“…The evidence on recent infection in relation to the incidence of SAH is limited. 14,24,30,52,58 The results of a Canadian study from the Calgary region were comparable with our findings and showed a small but significant increase in the incidence of SAH during influenza epidemics, with a delay between increased influenza and SAH rates of 0.9 week. 14 A case-control study found that an upper respiratory tract infection was an independent trigger factor for SAH, but this study included only 44 patients.…”

Section: Discussionsupporting

confidence: 89%

Increased incidence of subarachnoid hemorrhage during cold temperatures and influenza epidemics

Backes¹,

Rinkel²,

Algra

et al. 2016

JNS

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OBJECTIVE This study investigated whether the increased incidence of aneurysmal subarachnoid hemorrhage (SAH) in winter is related to temperature or increased incidence of influenza. Such relationships may elucidate the pathogenesis of intracranial aneurysm rupture. METHODS A nationwide sample of 18,714 patients with SAH was linked with weekly temperature and influenza-like illness consultation data. Poisson regression analyses were used to calculate incidence density ratios (IDRs) with corresponding 95% CIs for the association of SAH incidence with temperature and influenza epidemics; IDRs were adjusted for study year (aIDR). In addition, SAH incidence data from 30 European population-based studies were linked with daily temperature data from the European Climate Assessment. RESULTS The aIDR for SAH during influenza epidemics was 1.061 (95% CI 1.022–1.101) in the univariable and 1.030 (95% CI 0.989–1.074) in the multivariable analysis. This association declined gradually during the weeks after epidemics. Per 1°C temperature drop, the aIDR was 1.005 (95% CI 1.003–1.008) in the univariable and 1.004 (95% CI 1.002–1.007) in the multivariable analysis. In the European population-based studies, the IDR was 1.143 (95% CI 1.129–1.157) per 1°C temperature drop. CONCLUSIONS The incidence of SAH is increased during cold temperatures and epidemic influenza. Future studies with individual patient data are needed to investigate causality between temperature or influenza and SAH.

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Section: Discussionsupporting

confidence: 89%

Increased incidence of subarachnoid hemorrhage during cold temperatures and influenza epidemics

Backes¹,

Rinkel²,

Algra

et al. 2016

JNS

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“…Respiratory infections may play a role in this winter peak, especially due to the presence of influenza [27, 28], given that infections may trigger cerebral ischaemia through the activation of coagulation [29]. However, none of these hypotheses seem to provide a satisfactory explanation for this seasonal stroke profile and no studies analyse it based on the daily atmospheric variations during these seasons.…”

Section: Discussionmentioning

confidence: 99%

Weather as a Trigger of Stroke

et al. 2008

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Background: The conclusions of previous studies show little agreement concerning the relationship between weather and the incidence of stroke. We analyse the relationship between daily meteorological conditions and daily as well as seasonal stroke incidence. Methods: 1,286 consecutive strokes assessed during 3 years (2001–2003) from the reference area of Hospital del Mar were classified as intracerebral haemorrhage (ICH) (n = 243) or ischaemic stroke (IS) (n = 1,043). IS was divided in non-lacunar stroke (NLS) (n = 732) and lacunar stroke (LS) (n = 311). Daily meteorological data were obtained from ‘Observatori Fabra’ of Barcelona: atmospheric pressure (AP), relative humidity, maximum, minimum, and mean temperatures, and the variation of all these measures compared with the previous day. Results: Total stroke (TS) incidence showed little association with AP (coefficient of confidence, CC: –0.072; p = 0.022), but was higher with the AP variations (CC: 0.127; p < 0.001). NLS were related to AP falls (OR: 2.41; p < 0.001) whilst ICHs were associated with AP rises (OR: 2.07; p = 0.01). NLS and temperature showed an inverse correlation; however, it lost its significance after adjusting for AP variations. The daily incidences of NLS and ICH were higher in autumn and in winter, but depended strongly on the daily variations of AP. No other associations were found. Conclusions: The incidences of NLS and ICH are related to AP changes compared with the previous day. AP changes largely explain the seasonal and daily variations in the incidence of stroke. These data may help to explain the controversy in previous studies and to promote studies focused on the trigger mechanisms of stroke.

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“…Higher rates of cardiovascular events in winter and/or coincident with the influenza season have been reported [1,2,3,4,5]. Influenza has been estimated to cause as many as 90,000 cardiac deaths per annum by triggering acute coronary events [1].…”

Section: Introductionmentioning

confidence: 99%

The Influence of Oseltamivir Treatment on the Risk of Stroke after Influenza Infection

Madjid

Curkendall²,

Blumentals³

2008

Cardiology

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Objectives: It was the aim of this study to examine the influence of the antiviral medication oseltamivir on stroke and transient ischemic attack (TIA) in adults diagnosed with influenza. Methods: This retrospective cohort study used medical and pharmaceutical claims data from May 2000 to September 2006 from an administrative claims database. Episodes of stroke/TIA in the 6 months after influenza in adults (aged ≥18 years) prescribed oseltamivir within 1 day before or 2 days after influenza diagnosis (oseltamivir cohort), and adults prescribed no antivirals (comparison cohort) were compared using multivariate analyses adjusted for demographic and clinical risk factors. Results: The oseltamivir cohort comprised 49,238 patients and the comparison cohort 102,692 patients. Oseltamivir was associated with a 28% reduction in risk of stroke/TIA in the 6 months after influenza [hazard ratio (HR) 0.72; 95% CI 0.62–0.82] and with significant reductions after 1 and 3 months. In patients <65 years of age, there was a 34% risk reduction with oseltamivir after 6 months (HR 0.66; 95% CI 0.56–0.77) and also significant reductions after 1 and 3 months. In those aged ≥65 years, there was a 51% reduction in risk after 1 month (HR 0.49; 95% CI 0.27–0.91). Conclusions: Prescription of oseltamivir for influenza is associated with a reduced risk of stroke/TIA.

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Relationship between Supra-Annual Trends in Influenza Rates and Stroke Occurrence

Cited by 19 publications

References 21 publications

Increased incidence of subarachnoid hemorrhage during cold temperatures and influenza epidemics

Increased incidence of subarachnoid hemorrhage during cold temperatures and influenza epidemics

Weather as a Trigger of Stroke

The Influence of Oseltamivir Treatment on the Risk of Stroke after Influenza Infection

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