Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Relationship between Circadian Variation in Ictus of Aneurysmal Subarachnoid Hemorrhage and Physical Activity

  • Lee, Jong Min (Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Jung, Na Young (Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kim, Min Soo (Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Park, Eun Suk (Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Park, Jun Bum (Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Sim, Hong Bo (Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lyo, In Uk (Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kwon, Soon Chan (Department of Neurological Surgery, Ulsan University Hospital, University of Ulsan College of Medicine)
  • Received : 2019.03.04
  • Accepted : 2019.05.07
  • Published : 2019.09.01
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Abstract

Objective : The circadian pattern of the onset time of aneurysmal subarachnoid hemorrhage (aSAH) has been reported by various authors. However, the effect of the degree of physical exertion on the circadian pattern has not been studied in detail. Therefore, we conducted this study to investigate the effect of physical exertion on the circadian pattern of aSAH. Methods : Of the 335 patients presenting with aSAH from January 2012 to December 2017, 234 patients with identifiable onset time and metabolic equivalent (MET) values were enrolled. The onset time of aSAH was divided into 4-hour intervals. The patient's physical exertion was then assessed on a scale between 1 and 8 METs using generally accepted MET values, and categorized into two groups-light exertion (1 to 4 METs) and moderate to heavy exertion (5 to 8 METs)-to determine the effect of the degree of physical exertion on the onset time distribution of aSAH. Multivariate analysis was used to calculate the odds ratio (OR) between the two groups to determine the effect of the degree of physical exertion on each set of time periods. Results : There was a definite bimodal onset pattern that peaked at 08:00-12:00 hours followed by 16:00-20:00 hours (p<0.001). MET values at all time intervals were found to be significantly higher than the night time (00:00-04:00 hours) values (p<0.031). The MET value distribution showed a unimodal pattern that slightly differed from the bimodal distribution of the onset time of aSAH. There were no significant differences in the ORs of each time interval according to the degree of the MET value. Conclusion : This study reaffirmed that aSAH occurs in a bimodal pattern, especially showing the highest prevalence in the morning. Although aSAH could be related to daily activity, there were no significant changes in diurnal variations affected by the degree of physical exertion.

Keywords

References

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