A comparison of the effects of temperature change between neighboring days and diurnal temperature range on stroke incidence in rural Northwest

Studies on the effect of temperature variation on the number of hospitalizations for stroke-related diseases in rural Northwest China are rare, and there is a gap in related studies in Pingliang, a less developed city located in Northwest China. We collected hospitalization data for stroke patients covered by the New Rural Cooperative Medical Insurance in Pingliang City and meteorological data from the Gansu Meteorological Bureau. Using quasi-Poisson regression combined with distributed lag nonlinear models (DLNM), we compared the effects of temperature change between neighboring days (TCN) and diurnal temperature range (DTR) on stroke-related hospitalizations in rural areas. The analysis indicated that DTR exerted a significantly greater impact on stroke incidence than TCN (RR = 1.267, 95% CI: 1.193-1.346 vs. RR = 1.168, 95% CI: 1.055-1.293). Both DTR and TCN exhibited a nonlinear U-shaped relationship. Sex-stratified analysis revealed that men were more adversely affected by low TCN and DTR levels than women, whereas women exhibited a greater susceptibility to high TCN levels. An age-stratified analysis indicated that adults were more vulnerable to the effects of DTR than elderly, who were more affected by high TCN. No significant differences were observed across the age groups under low TCN conditions.