Air pollution impacts on in-hospital case-fatality rate of ischemic stroke patients
Karsten Keller, Seyed Hamed Rastguye Haghi, Omar Hahad, Irene Schmidtmann, Sourangsu Chowdhury, Jos Lelieveld, Thomas Münzel, Lukas Hobohm
Abstract
BACKGROUND: A growing body of evidence suggests that air pollution exposure is associated with an increased risk for cardiovascular diseases. Data regarding the impact of long-term air pollution exposure on ischemic stroke mortality are sparse. METHODS: The German nationwide inpatient sample was used to analyse all cases of hospitalized patients with ischemic stroke in Germany 2015-2019, which were stratified according to their residency. Data of the German Federal Environmental Agency regarding average values of air pollutants were assessed from 2015 to 2019 at district-level. Data were combined and the impact of different air pollution parameters on in-hospital case-fatality was analyzed. RESULTS: concentrations were significantly associated with stroke-case-fatality rate of >8 % independent of residence area-type and area use (OR 1.518 [95%CI 1.012-2.278],P = 0.044). CONCLUSION: , were associated with increased stroke mortality of patients. RESEARCH IN CONTEXT: are independently associated with increased case-fatality of hospitalized patients with ischemic stroke in Germany. Implications of all the available evidence: The results of our study support the urgent need to reduce the exposure to air pollution by tightening emission controls to reduce the stroke burden and stroke mortality.