P063. Association Between Long-term Exposure to Ambient Air Pollution and Hospitalization With Aortic Aneurysm or Aortic Dissection
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
University of Missouri-Kansas City School of Medicine
Kansas City, MO
United States - Contact Me
Kanhua Yin is a general surgery resident at Universaity of Missouri-Kansas City. His research focuses on leveraging national healthcare databases to assess population-level surgical outcomes of aortic aneurysms/aortic dissection.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objective: The environmental contributions to the development of aortic aneurysms or aortic dissection are poorly understood, though emerging evidence suggests a correlation between air pollution and increased risks of various cardiovascular diseases. This study utilized a validated population-level air pollution exposure model and a national clinical database to assess the associations between long-term exposures to fine particulate matter (PM2.5), ozone, and nitrogen dioxide (NO2) - key air pollutants regulated by the US Environmental Protection Agency - and hospitalizations related to aortic aneurysms or dissections.
Methods: Annual concentration levels of PM2.5, warm-season ozone, and NO2 at 1 km2 grid cells were estimated based on three machine-learning models combined with geographically weighted regressions. Predictors encompassed satellite data, land use, meteorological, and ancillary variables. Data were aggregated from 1 km2 grid cells to ZIP codes to match the spatial resolution of hospitalization records. Hospitalization records for residents of 14 U.S. states (2000-2016) were obtained from the State Inpatient Databases (SIDs). ICD-9 (441) and ICD-10 (I-71) codes were used to identify aortic aneurysm and aortic dissection-related hospitalizations. Hospitalization rates were calculated at the ZIP code level. A multivariable linear regression model was built to estimate associations between annual air pollutant levels and hospitalization rates, adjusting for patient demographics, neighborhood-level covariates, and seasonal temperatures during summer and winter. Penalized cubic splines with up to nine degrees of freedom were used for all three pollutants to estimate nonlinear exposure-response relationships.
Results: Analysis included 338, 381 hospitalizations related to aortic aneurysm or dissection (mean age 70.8 years, 71.8% male, and 70.0% Caucasian). Average annual PM2.5, warm-season ozone, and NO2 levels were 9.2 µg/m3, 44.7 parts per billion (ppb), and 17.1 ppb, respectively. All three pollutants were associated with increased hospitalization rates, with the effects of PM2.5 and NO2 being statistically significant. PM2.5 displayed a more pronounced effect, demonstrating that each unit increase in annual exposure correlated with 16.7 additional hospitalizations (95% confidence interval: 10.5, 22.9, p < 0.001) per ten million person-years, followed by NO2, which exhibited 1.85 additional hospitalizations (95% confidence interval: 0.03-3.7, p < 0.05) per ten million person-years. A clear exposure-effect relationship was observed for PM2.5 and NO2 (Figure 1).
Conclusions: Long-term exposures to PM2.5 and NO2 are independently associated with an elevated risk of hospitalization related to aortic aneurysm or aortic dissection, with PM2.5 being a more deleterious pollutant. This study underscores the potential role of air pollution in the development or progression of aortic aneurysm/dissection.
Authors
Kanhua Yin (1), Yaguang Wei (2), Joel Schwartz (2)
Institutions
(1) Department of Surgery, University of Missouri-Kansas City, Kansas City, MO, (2) Harvard T.H. Chan School of Public Health, Boston, MA
Methods: Annual concentration levels of PM2.5, warm-season ozone, and NO2 at 1 km2 grid cells were estimated based on three machine-learning models combined with geographically weighted regressions. Predictors encompassed satellite data, land use, meteorological, and ancillary variables. Data were aggregated from 1 km2 grid cells to ZIP codes to match the spatial resolution of hospitalization records. Hospitalization records for residents of 14 U.S. states (2000-2016) were obtained from the State Inpatient Databases (SIDs). ICD-9 (441) and ICD-10 (I-71) codes were used to identify aortic aneurysm and aortic dissection-related hospitalizations. Hospitalization rates were calculated at the ZIP code level. A multivariable linear regression model was built to estimate associations between annual air pollutant levels and hospitalization rates, adjusting for patient demographics, neighborhood-level covariates, and seasonal temperatures during summer and winter. Penalized cubic splines with up to nine degrees of freedom were used for all three pollutants to estimate nonlinear exposure-response relationships.
Results: Analysis included 338, 381 hospitalizations related to aortic aneurysm or dissection (mean age 70.8 years, 71.8% male, and 70.0% Caucasian). Average annual PM2.5, warm-season ozone, and NO2 levels were 9.2 µg/m3, 44.7 parts per billion (ppb), and 17.1 ppb, respectively. All three pollutants were associated with increased hospitalization rates, with the effects of PM2.5 and NO2 being statistically significant. PM2.5 displayed a more pronounced effect, demonstrating that each unit increase in annual exposure correlated with 16.7 additional hospitalizations (95% confidence interval: 10.5, 22.9, p < 0.001) per ten million person-years, followed by NO2, which exhibited 1.85 additional hospitalizations (95% confidence interval: 0.03-3.7, p < 0.05) per ten million person-years. A clear exposure-effect relationship was observed for PM2.5 and NO2 (Figure 1).
Conclusions: Long-term exposures to PM2.5 and NO2 are independently associated with an elevated risk of hospitalization related to aortic aneurysm or aortic dissection, with PM2.5 being a more deleterious pollutant. This study underscores the potential role of air pollution in the development or progression of aortic aneurysm/dissection.
Authors
Kanhua Yin (1), Yaguang Wei (2), Joel Schwartz (2)
Institutions
(1) Department of Surgery, University of Missouri-Kansas City, Kansas City, MO, (2) Harvard T.H. Chan School of Public Health, Boston, MA
Presentation Duration
PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing.