Role of meteorological factors in duodenal ulcer seasonality

A nation-wide, population-based study

Sudha Xirasagar, Herng Ching Lin, Chin Shyan Chen

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: Understanding disease seasonality can provide guidance for future biomedical research. OBJECTIVE: To examine whether meteorological factors and calendar months impact duodenal ulcer (DU) exacerbations. DESIGN: We conducted a retrospective time series analysis of population-based claims data. PARTICIPANTS: DU inpatients (1997-2003; all endoscopy confirmed) from Taiwan, a small island nation, n = 160,510. Inpatient admission was used as a proxy for exacerbation because 98.5% of cases had hemorrhage or perforation or both. MEASUREMENTS: We used multivariate autoregressive integrated moving average (ARIMA) modeling to examine if DU admissions/100,000 was associated with calendar month, ambient temperature, relative humidity, rainfall, atmospheric pressure, and sunshine hours, controlling for available DU-relevant comorbidities. RESULTS: DU admissions increased with age. ARIMA modeling showed a February (Chinese New Year-related) trough in all age groups (all p <0.001; adjusted for meteorological variables and comorbidities), consistent with a February dip in all-cause admissions. Among 35-49 and 50+ age groups, DU admissions were negatively associated with temperature (both p <0.05; model R 2 = 0.875 and 0.920, respectively), representing a winter peak and summer trough. Among the ≤19 age group, sunshine hours and rainfall are positively associated with DU admissions (both p <0.001; R 2 = 0.565), representing a summer peak. CONCLUSION: Meteorological variables are associated with DU exacerbations, although the potential role of nonsteroidal anti-inflammatory drug (NSAID) use because of seasonal acute respiratory illness cannot be ruled out. We recommend in-depth studies using chart reviews of DU patients admitted during peak and trough (incidence) months to clarify whether meteorological factors or the associated seasonal peaks of respiratory and other illnesses involving NSAID use are responsible for the observed seasonality.

Original languageEnglish
Pages (from-to)1439-1446
Number of pages8
JournalJournal of General Internal Medicine
Volume22
Issue number10
DOIs
Publication statusPublished - Oct 2007

Fingerprint

Meteorological Concepts
Duodenal Ulcer
Population
Age Groups
Sunlight
Comorbidity
Inpatients
Anti-Inflammatory Agents
Temperature
Atmospheric Pressure
Proxy
Humidity
Taiwan
Islands
Pharmaceutical Preparations
Endoscopy
Biomedical Research
Hemorrhage

Keywords

  • Climate
  • Duodenal ulcer
  • Seasonality

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Role of meteorological factors in duodenal ulcer seasonality : A nation-wide, population-based study. / Xirasagar, Sudha; Lin, Herng Ching; Chen, Chin Shyan.

In: Journal of General Internal Medicine, Vol. 22, No. 10, 10.2007, p. 1439-1446.

Research output: Contribution to journalArticle

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title = "Role of meteorological factors in duodenal ulcer seasonality: A nation-wide, population-based study",
abstract = "BACKGROUND: Understanding disease seasonality can provide guidance for future biomedical research. OBJECTIVE: To examine whether meteorological factors and calendar months impact duodenal ulcer (DU) exacerbations. DESIGN: We conducted a retrospective time series analysis of population-based claims data. PARTICIPANTS: DU inpatients (1997-2003; all endoscopy confirmed) from Taiwan, a small island nation, n = 160,510. Inpatient admission was used as a proxy for exacerbation because 98.5{\%} of cases had hemorrhage or perforation or both. MEASUREMENTS: We used multivariate autoregressive integrated moving average (ARIMA) modeling to examine if DU admissions/100,000 was associated with calendar month, ambient temperature, relative humidity, rainfall, atmospheric pressure, and sunshine hours, controlling for available DU-relevant comorbidities. RESULTS: DU admissions increased with age. ARIMA modeling showed a February (Chinese New Year-related) trough in all age groups (all p <0.001; adjusted for meteorological variables and comorbidities), consistent with a February dip in all-cause admissions. Among 35-49 and 50+ age groups, DU admissions were negatively associated with temperature (both p <0.05; model R 2 = 0.875 and 0.920, respectively), representing a winter peak and summer trough. Among the ≤19 age group, sunshine hours and rainfall are positively associated with DU admissions (both p <0.001; R 2 = 0.565), representing a summer peak. CONCLUSION: Meteorological variables are associated with DU exacerbations, although the potential role of nonsteroidal anti-inflammatory drug (NSAID) use because of seasonal acute respiratory illness cannot be ruled out. We recommend in-depth studies using chart reviews of DU patients admitted during peak and trough (incidence) months to clarify whether meteorological factors or the associated seasonal peaks of respiratory and other illnesses involving NSAID use are responsible for the observed seasonality.",
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AB - BACKGROUND: Understanding disease seasonality can provide guidance for future biomedical research. OBJECTIVE: To examine whether meteorological factors and calendar months impact duodenal ulcer (DU) exacerbations. DESIGN: We conducted a retrospective time series analysis of population-based claims data. PARTICIPANTS: DU inpatients (1997-2003; all endoscopy confirmed) from Taiwan, a small island nation, n = 160,510. Inpatient admission was used as a proxy for exacerbation because 98.5% of cases had hemorrhage or perforation or both. MEASUREMENTS: We used multivariate autoregressive integrated moving average (ARIMA) modeling to examine if DU admissions/100,000 was associated with calendar month, ambient temperature, relative humidity, rainfall, atmospheric pressure, and sunshine hours, controlling for available DU-relevant comorbidities. RESULTS: DU admissions increased with age. ARIMA modeling showed a February (Chinese New Year-related) trough in all age groups (all p <0.001; adjusted for meteorological variables and comorbidities), consistent with a February dip in all-cause admissions. Among 35-49 and 50+ age groups, DU admissions were negatively associated with temperature (both p <0.05; model R 2 = 0.875 and 0.920, respectively), representing a winter peak and summer trough. Among the ≤19 age group, sunshine hours and rainfall are positively associated with DU admissions (both p <0.001; R 2 = 0.565), representing a summer peak. CONCLUSION: Meteorological variables are associated with DU exacerbations, although the potential role of nonsteroidal anti-inflammatory drug (NSAID) use because of seasonal acute respiratory illness cannot be ruled out. We recommend in-depth studies using chart reviews of DU patients admitted during peak and trough (incidence) months to clarify whether meteorological factors or the associated seasonal peaks of respiratory and other illnesses involving NSAID use are responsible for the observed seasonality.

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