Weather-related triggers of acute aortic dissection: a case-crossover study of 293 patients

This study utilized a case-crossover design to assess the acute, transient trigger effect of weather-related factors on acute aortic dissection (AAD) onset, while inherently controlling for all stable individual-level confounders.

This retrospective, single-center case-crossover study included 293 consecutive patients with AAD treated at a tertiary care center between January 2019 and December 2021. For each patient, the day of AAD onset (case period) was compared with the seven preceding days (control periods). Daily weather-related data, including mean temperature and day-to-day temperature change, were obtained. Conditional logistic regression analysis was performed to estimate the acute risk of AAD onset associated with weather-related variables, allowing for the matching of patient-specific, time-invariant factors.

Multivariate conditional logistic regression analysis identified two weather-related factors independently associated with AAD onset: mean temperature and the change in minimum temperature from the previous day. A decrease in mean temperature significantly increased the risk of AAD; the risk increased by 1.13 times (95% CI: 1.06-1.20) for every 1℃ decrease in mean temperature. Similarly, a larger drop in minimum temperature from the previous day acutely increased the risk; the risk increased by 1.04 times (95% CI: 1.01-1.08) for every 1 ℃ decrease in minimum temperature from the previous day.

The onset of AAD is acutely triggered by low mean temperature and a significant drop in minimum temperature from the previous day, independent of individual patient risk factors.