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Different Mortality of Ischemic and Hemorrhagic Stroke in Relation to Outdoor Temperature

Hong, Yun-Chul1,2; Lim, Youn-Hee3; Oh, Se-Young4; Park, Minseon5; Kim, Ho3

doi: 10.1097/01.ede.0000391740.77935.f4
Abstracts: ISEE 22nd Annual Conference, Seoul, Korea, 28 August–1 September 2010: Climate Change and Environmental Health

1Seoul National University College of Medicine, Seoul, Republic of Korea; 2Medical Research Center, Seoul National University Seoul, Republic of Korea; 3School of Public Health, Seoul National University School of Public Health, Seoul, Republic of Korea; 4Kyung Hee University, Seoul, Republic of Korea; and 5Seoul National University Hospital, Seoul, Republic of Korea.

Abstracts published in Epidemiology have been reviewed by the societies at whose meetings the abstracts have been accepted for presentation. These abstracts have not undergone review by the Editorial Board of Epidemiology.


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Outdoor temperature has been reported to have a significant influence on the seasonal variations in mortality of stroke, but different mortality of ischemic and hemorrhagic strokes in response to outdoor temperature was not evaluated. The main goal of the study was to examine the effect of temperature on ischemic and hemorrhagic strokes, particularly for extreme temperature.

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We investigated the association between outdoor temperature and stroke mortality in Seoul during 1992–2007. We used time series analysis of the counts for ischemic and hemorrhagic stroke deaths by means of the generalized additive and generalized linear models, and estimated the % change of mortality associated with 1°C increase in outdoor temperature.

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The estimated % change of mortality for hemorrhagic cerebral disease were 0.36 (95% CI: −0.08, 0.81) below 10°C and −0.53 (−1.06, 0.0) at 10°C or higher with 1°C increase in outdoor temperature. For the ischemic cerebral disease, the estimated % changes were 0.59 (0.25, 0.93) below 23°C and 3.30 (2.22, 4.38) at 23°C or higher.

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These findings support the hypothesis that mortality of ischemic and hemorrhagic strokes show different patterns in relation to outdoor temperature. The ischemic stroke is more responsive to outdoor temperature and both extreme temperatures, cold and hot, were harmful for ischemic stroke.

© 2011 Lippincott Williams & Wilkins, Inc.