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Seasonal variations in hospital admissions and case-fatality of ischemic stroke: A nationwide analysis of >4.2 million cases in Germany.
Front. Epidemiol. 6, DOI: 10.3389/fepid.2026.1750089 (2026)
Background: Ischemic
stroke is a leading cause of global morbidity and mortality, with
seasonal variations potentially influencing both outcomes. While
previous studies have suggested a pronounced association of the cold
months with increased stroke morbidity and mortality, the evidence
remains limited and inconsistent. This study aimed to assess seasonal
variations in ischemic stroke hospital admissions and in-hospital
case-fatality and complications in Germany over an 18-year period.Methods: This
nationwide retrospective analysis included all hospitalizations for
ischemic stroke in Germany from 2005 to 2022, using data from the
Federal Statistical Office. Patients were categorized by season of
hospital admission (winter, spring, summer, autumn). Multivariable
logistic regression models were used to assess the association between
season and in-hospital case-fatality, adjusting for age, sex, and
comorbidities.Results: A
total of 4,236,789 ischemic stroke hospitalizations were analyzed. No
statistically significant seasonal variation in stroke hospitalization
was observed. However, in-hospital case-fatality was significantly
higher in winter (7.4%) compared to summer (6.6%, p < 0.001).
This seasonal association was independent of patient age, sex, and
comorbidities [adjusted odds ratio (OR): 1.140, 95% confidence interval
(CI): 1.128–1.152; p < 0.001]. Similar trends were observed in both men (adjusted OR: 1.122, 95% CI: 1.103–1.141; p < 0.001) and women (adjusted OR: 1.112, 95% CI: 1.096–1.128; p < 0.001), without substantial sex-specific differences.Conclusion: While
ischemic stroke hospital admissions remained stable across seasons,
in-hospital case-fatality was significantly increased during winter
compared to summer. These findings highlight the need for targeted
seasonal prevention and management strategies. Further research is
needed to explore underlying mechanisms and evaluate potential
interventions to mitigate excess winter case-fatality among stroke
patients.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Stroke (engine) ; Ischemic Stroke ; Confidence Interval ; Logistic Regression ; Odds Ratio ; Seasonality ; Odds ; Psychological Intervention
ISSN (print) / ISBN
2674-1199
e-ISSN
2674-1199
Zeitschrift
Frontiers in epidemiology
Quellenangaben
Band: 6
Verlag
Frontiers
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Epidemiology (EPI)