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Original article Seasonal impact of diurnal temperature range on intracerebral hemorrhage in middle-aged and elderly people in central China
Shiwen Wang1,2orcid , Jinyu Yin1orcid , Hao Zhou1orcid , Jingmin Lai1orcid , Guizheng Xiao1orcid , Zhuoya Tong1orcid , Jing Deng1orcid , Fang Yang1orcid , Qianshan Shi3orcid , jingcheng shi1orcid
Epidemiol Health 2024;e2024053
DOI: https://doi.org/10.4178/epih.e2024053 [Accepted]
Published online: June 11, 2024
1Department of Epidemiology and Medical Statistics, Central South University, Changsha, Hunan, China, Hunan Province, China
2Discipline Construction Office of XiangYa Hospital, Central South University, Changsha, China
3Information Statistics Center of Health Commission of Hunan Province, Changsha, Hunan, China , Hunan Province, China
Corresponding author:  jingcheng shi,
Email: jingzhengs@126.com
Received: 31 January 2024   • Revised: 8 May 2024   • Accepted: 18 May 2024
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This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults.
We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag nonlinear model.
Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a nonlinear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period.
The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

Epidemiol Health : Epidemiology and Health