Monday, 11 January 2016
BACKGROUND Chronic disease is a complex phenomenon defined by individual risk factors and its geographic context. Because interaction of those multiple causes is very difficult to apprehend, the analytic approach between a possible risk factor and the health event has been the main strategy to understand primary relationships. The aim of this study was to investigate the influence of meteorological variables on pulmonary embolism mortality in São Paulo municipality. METHODS: Daily mortality for pulmonary embolism, meteorological variables and air pollution data were obtained for the period of January 2002 to December 2011. The percentage increase of mortality was estimated with endpoint-specific generalized additive Poisson regression models. Effects of mean temperature, humidity, thermal amplitude, barometric pressure and air pollutants were assessed using specific third-degree polynomial distributed lag models for a time window of eight days. The models were controlled for humidity, atmospheric pressure, thermal amplitude and pollutants. RESULTS: In the ten years of study mortality from pulmonary embolism was more than seven thousand cases. Mortality was assessed by age groups and by gender. Regression models were made for all weather variables, however only thermal amplitude showed a significant result (p = 0.05). To an increase in thermal amplitude of 1ºC we observed an estimated percentage increase of 3.7% (CI 95%, 0.1-7.4) in total pulmonary embolism mortality for each interquartile range. For women of all ages the increase was 10.4% (CI 95%, 1.7-18.5) and for men 13.9% (CI 95% 4-23.8). For men above 65 years the pulmonary embolism mortality increased 8.7% (CI 95%, 0.7-16.6) for each 1ºC increase in thermal amplitude. Just for women with the same age no significative association was observed with thermal amplitude. CONCLUSION: Pulmonary Embolism is considered very common in hospitalized patients, a major cause of hospital mortality and a significant cause of death overall. The age group above 40 years is more common in cases of pulmonary embolism (ANDREI et al. 2013). As a result of this research we found that the thermal amplitude affects pulmonary embolism mortality especially, in mens. This result is especially important in countries where the variation of daily temperature is too high and can cause blood circulation problems. In view of the urgent care for pulmonary embolism cases can prevent deaths and serious consequences, a better understanding of the importance of geographical context may allow the development of alerts next to the urgent care service systems and targeting campaigns to prevent avoidable risk factors.
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