Association between ambient temperature and acute type A aortic dissection in a Korean population: a 12-year dual-scale Poisson regression analysis.

BACKGROUND: Whether absolute temperature or day-to-day temperature fluctuation more strongly precipitates acute type A aortic dissection (ATAAD) remains unresolved, particularly in East Asian populations with distinct temperate-monsoon climates. This study investigated the association between meteorological factors and ATAAD occurrence in a Korean population over a 12-year period. METHODS: Clinical data from 522 patients who underwent open surgical repair for ATAAD at a single tertiary center between January 2008 and December 2019 were retrospectively analyzed alongside meteorological data obtained from the Korea Meteorological Administration. Primary analyses focused on temperature variables-mean, lowest, and perceived (apparent) temperature on the day of onset and the previous day, as well as day-to-day temperature change-using Pearson correlation coefficients and Poisson regression models at both monthly and daily temporal scales. RESULTS: ATAAD incidence demonstrated a marked winter predominance, peaking in December (n=65, 12.5%) and reaching its nadir in July (n=24, 4.6%); cold-season months (November-March) collectively accounted for 273 cases (52.3%). A strong negative correlation was observed between monthly ATAAD occurrence and all absolute temperature variables (r=-0.83 to -0.85, all P<0.001). Every 10 ℃ decrease in mean onset-day temperature was associated with a 26.8% increase in monthly incidence rate [incidence rate ratio (IRR): 1.268, 95% CI: 1.151-1.395, P<0.001] and a 7.4% increase in daily incidence rate (IRR 1.074, 95% CI: 1.012-1.139, P=0.02). Day-to-day temperature change was not significantly associated with ATAAD occurrence at either temporal scale (all P≥0.63). CONCLUSIONS: In a Korean population, lower absolute ambient temperature was significantly associated with increased ATAAD occurrence on both monthly and daily analyses, whereas day-to-day temperature fluctuation showed no statistically significant association. Heightened clinical awareness during cold seasons may contribute to earlier recognition and improved outcomes in high-risk patients.