Seasonal and Weekly Variations in Acute Ischemic Stroke Admissions among COPD Patients

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading global cause of mortality, with incidence and prevalence on an upward trajectory.While firmly associated with cardiovascular disease, recent studies have shed light on a potential link between COPD and stroke.We aim to analyze the association between COPD and stroke while exploring seasonal and weekly variations in Acute Ischemic Stroke (AIS) admissions in our center. Methods:Retrospectively identified patients with COPD from January 2004 to December 31 st , 2018, who had AIS.Risk factors and seasonal, monthly, and weekly variations in admission patterns were recorded.Results: A total of 329 cases of COPD with AIS admissions were identified, alongside 347 AIS patients without COPD matched by age and sex as a control group.The mean age at the time of AIS was 74.9 10.7 years for the COPD group and 75.2 11.5 years for the non-COPD group (p=NS).In the COPD group, 66% were males, compared to 58.8% in the control group (p=NS).Notably, the COPD cohort exhibited a higher prevalence of risk factors, including hypertension, hyperlipidemia, smoking, and ischemic heart disease.Seasonal variations were apparent, with winter showcasing the highest number of admissions in both groups, although no statistically significant difference was observed in the overall seasonal distribution.While no significant disparities were noted in the half-year distribution of AIS between groups, a higher incidence of strokes occurred during the cold half-year.Significant differences emerged in the distribution of AIS between weekdays and weekends.COPD patients demonstrated a higher frequency of AIS admissions on weekends compared to the control group (27.36% vs. 17%, p=0.0011). Conclusion:This study highlights the influence of chronobiological factors on AIS in COPD patients.While no significant differences were identified in overall seasonal patterns, the distinct weekday and weekend admission rates suggest a potential role for weekly variations in stroke occurrence.