■猝死约占工作年龄成年人死亡人数的10%,并且与空气质量差有关。目标:确定高风险人群和潜在的风险调节剂和介体,我们探讨了先前建立的细颗粒物(PM2.5)与按潜在危险因素分层的猝死之间的关联.
■韦克县的猝死受害者,NC,在2013年3月1日至2015年2月28日期间,通过急诊医疗系统筛查报告进行鉴定并作出裁决(n=399).空气质量数据集市上威克县的每日PM2.5浓度与事件和控制期有关。潜在的修饰符包括绿色空间指标,临床状况,左心室肥厚(LVH),和中性粒细胞与淋巴细胞比率(NLR)。使用案例交叉设计,条件逻辑回归估计猝死的OR(95CI)为PM2.5增加5μg/m3,滞后1天,根据温度和湿度进行调整,跨风险因素阶层。
■LVH或NLR高于2.5的个体的PM2.5相关性比没有[LVHOR:1.90(1.04,3.50);NLR>2.5:1.25(0.89,1.76)]的个体。PM2.5对居住在绿色空间较高地区的个人的影响通常较小。
■LVH和炎症可能是不良空气质量和传统危险因素引发心律失常或心肌缺血和猝死的因果途径的最后一步。统计证据与临床知识的结合可以告知医疗提供者其患者的潜在风险。虽然我们的发现可能有助于指导干预措施以减轻猝死的发生率。
UNASSIGNED: Sudden death accounts for approximately 10% of deaths among working-age adults and is associated with poor air quality. Objectives: To identify high-risk groups and potential modifiers and mediators of risk, we explored previously established associations between fine particulate matter (PM2.5) and sudden death stratified by potential risk factors.
UNASSIGNED: Sudden death victims in Wake County, NC, from 1 March 2013 to 28 February 2015 were identified by screening Emergency Medical Systems
reports and adjudicated (n = 399). Daily PM2.5 concentrations for Wake County from the Air Quality Data Mart were linked to event and control periods. Potential modifiers included greenspace metrics, clinical conditions, left ventricular hypertrophy (LVH), and neutrophil-to-lymphocyte ratio (NLR). Using a
case-crossover design, conditional logistic regression estimated the OR (95%CI) for sudden death for a 5 μg/m3 increase in PM2.5 with a 1-day lag, adjusted for temperature and humidity, across risk factor strata.
UNASSIGNED: Individuals having LVH or an NLR above 2.5 had PM2.5 associations of greater magnitude than those without [with LVH OR: 1.90 (1.04, 3.50); NLR > 2.5: 1.25 (0.89, 1.76)]. PM2.5 was generally less impactful for individuals living in areas with higher levels of greenspace.
UNASSIGNED: LVH and inflammation may be the final step in the causal pathway whereby poor air quality and traditional risk factors trigger arrhythmia or myocardial ischemia and sudden death. The combination of statistical evidence with clinical knowledge can inform medical providers of underlying risks for their patients generally, while our findings here may help guide interventions to mitigate the incidence of sudden death.