Gustavo Saposnik, MD, MSc, Akerke Baibergenova, MD, PhD, Jason Dang and Vladimir Hachinski, MD, DSc, FRCP(C)
From the Stroke Team (G.S., V.H.), Department of Clinical Neurological Sciences, London Health Sciences Center, University of Western Ontario; Stroke Research Program (G.S.), Department of Medicine, Division of Neurology, University of Toronto; Department of Clinical Epidemiology and Biostatistics (A.B.), McMaster University, Hamilton; and Department of Applied Health Sciences (J.D.), University of Waterloo, Ontario, Canada.
Objective: To examine the influence of birthdays on the onset and course of vascular events such as stroke, TIA, and acute myocardial infarction (AMI).
Methods: This population-based study included all emergency department (ED) admissions due to ischemic stroke, TIA, or AMI from April 2002 to March 2004 in Ontario, Canada. All cases were identified through the National Ambulatory Care Reporting System. Calculations of daily and weekly numbers of events were centered on the patient’s birthday and the week of the birthday. Statistical analyses include binomial tests and logistic regression.
Results: During the study period, there were 24,315 ED admissions with acute stroke, 16,088 with TIAs, and 29,090 with AMI. The observed number of vascular events during the birthday was higher than the expected daily number of visits for stroke (87 vs 67; p = 0.009), TIA (58 vs 44; p = 0.02), and AMI (97 vs 80; p = 0.027) but not for selected control conditions (asthma, appendicitis, head trauma). Vascular events were more likely to occur on birthday (242 vs 191; odds ratio [OR] = 1.27). No significant differences were observed during the birthday week for any of the conditions. Multivariate logistic regression showed that birthday vascular events were more likely to occur in patients with a history of hypertension (OR = 1.88; 95% CI 1.09 to 3.24). Sensitivity analyses with alternative definitions of birthday week did not alter the results.
Conclusions: Stress associated with birthdays may trigger vascular events in patients with predisposing conditions. Full Text
Methods: This population-based study included all emergency department (ED) admissions due to ischemic stroke, TIA, or AMI from April 2002 to March 2004 in Ontario, Canada. All cases were identified through the National Ambulatory Care Reporting System. Calculations of daily and weekly numbers of events were centered on the patient’s birthday and the week of the birthday. Statistical analyses include binomial tests and logistic regression.
Results: During the study period, there were 24,315 ED admissions with acute stroke, 16,088 with TIAs, and 29,090 with AMI. The observed number of vascular events during the birthday was higher than the expected daily number of visits for stroke (87 vs 67; p = 0.009), TIA (58 vs 44; p = 0.02), and AMI (97 vs 80; p = 0.027) but not for selected control conditions (asthma, appendicitis, head trauma). Vascular events were more likely to occur on birthday (242 vs 191; odds ratio [OR] = 1.27). No significant differences were observed during the birthday week for any of the conditions. Multivariate logistic regression showed that birthday vascular events were more likely to occur in patients with a history of hypertension (OR = 1.88; 95% CI 1.09 to 3.24). Sensitivity analyses with alternative definitions of birthday week did not alter the results.
Conclusions: Stress associated with birthdays may trigger vascular events in patients with predisposing conditions. Full Text
http://www.neurology.org/cgi/content/abstract/67/2/300
NEUROLOGY 2006;67:300-304
© 2006 American Academy of Neurology
No comments:
Post a Comment