Once after a full moon: acute type A aortic dissection and lunar phases
Abstract OBJECTIVES Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was under...
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| Published in | Interactive cardiovascular and thoracic surgery Vol. 34; no. 1; pp. 105 - 110 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Oxford University Press
01.01.2022
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Abstract
OBJECTIVES
Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD.
METHODS
We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period).
RESULTS
The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00–1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01–1.23, P = 0.027). The peak incidence came 4–6 days after the moon was fully illuminated.
CONCLUSIONS
This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.
The impact our nearest celestial body has on our ecosystem, society and humans has been studied and debated for at least 20 000 years [1] when humans first started to record the lunar cycle. |
|---|---|
| AbstractList | Abstract
OBJECTIVES
Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD.
METHODS
We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period).
RESULTS
The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00–1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01–1.23, P = 0.027). The peak incidence came 4–6 days after the moon was fully illuminated.
CONCLUSIONS
This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable. Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD.We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period).The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P=0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P=0.027). The peak incidence came 4-6days after the moon was fully illuminated.This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable. OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. METHODS: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period). RESULTS: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated. CONCLUSIONS: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable. Abstract OBJECTIVES Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. METHODS We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period). RESULTS The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00–1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01–1.23, P = 0.027). The peak incidence came 4–6 days after the moon was fully illuminated. CONCLUSIONS This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable. The impact our nearest celestial body has on our ecosystem, society and humans has been studied and debated for at least 20 000 years [1] when humans first started to record the lunar cycle. Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period). The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated. This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable. OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. METHODS: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period). RESULTS: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated. CONCLUSIONS: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable. |
| Author | Bjurbom, Markus Sjögren, Johan Olsson, Christian Ahlsson, Anders Oudin Åström, Daniel Hansson, Emma C Geirsson, Arnar Oudin, Anna Juvonen, Tatu Joost Holdflod Møller, Christian Gudbjartsson, Tomas Nozohoor, Shahab Raivio, Peter Pan, Emily Bjursten, Henrik Mennander, Ari Ahmad, Khalil Wickbom, Anders Zindovic, Igor Tang, Mariann Olsen, Peter S Jormalainen, Miko Jeppsson, Anders |
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| Keywords | Moon Dissection of the aorta |
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| References_xml | – volume: 110 start-page: 575 year: 2019 ident: 2022010923082746900_ivab220-B6 article-title: Chronologic and climatic factors of acute aortic dissection: study of 1642 patients in two continents publication-title: Ann Thorac Surg doi: 10.1016/j.athoracsur.2019.11.013 contributor: fullname: Ma – volume: 23 start-page: 1485 year: 2013 ident: 2022010923082746900_ivab220-B24 article-title: Evidence that the lunar cycle influences human sleep publication-title: Curr Biol doi: 10.1016/j.cub.2013.06.029 contributor: fullname: Cajochen – volume: 37 start-page: 217 year: 1958 ident: 2022010923082746900_ivab220-B21 article-title: Dissecting aneurysm of the aorta: a review of 505 cases publication-title: Medicine (Baltimore) doi: 10.1097/00005792-195809000-00003 contributor: fullname: Hirst – volume: 10 start-page: 7434 year: 2020 ident: 2022010923082746900_ivab220-B30 article-title: Incidence of acute type A aortic dissection in emergency departments publication-title: Sci Rep doi: 10.1038/s41598-020-64299-4 contributor: fullname: Wundram – volume: 110 start-page: 462 year: 2008 ident: 2022010923082746900_ivab220-B4 article-title: Impact of the lunar cycle on the incidence of intracranial aneurysm rupture: myth or reality? publication-title: Clin Neurol Neurosurg doi: 10.1016/j.clineuro.2008.02.001 contributor: fullname: Ali – volume: 17 start-page: 818 year: 2013 ident: 2022010923082746900_ivab220-B7 article-title: The influence of seasons and lunar cycle on hospital outcomes following ascending aortic dissection repair publication-title: Interact CardioVasc Thorac Surg doi: 10.1093/icvts/ivt299 contributor: fullname: Shuhaiber – volume: 40 start-page: 1261 year: 2004 ident: 2022010923082746900_ivab220-B3 article-title: Regarding “Lunar cycles and abdominal aortic aneurysm rupture” publication-title: J Vasc Surg doi: 10.1016/j.jvs.2004.09.029 contributor: fullname: Takagi – volume: 23 start-page: 60 year: 2017 ident: 2022010923082746900_ivab220-B5 article-title: Secular pattern of aneurysmal rupture with the lunar cycle and season publication-title: Interv Neuroradiol doi: 10.1177/1591019916675632 contributor: fullname: Banfield – volume: 133 start-page: 144 year: 1991 ident: 2022010923082746900_ivab220-B10 article-title: The case-crossover design: a method for studying transient effects on the risk of acute events publication-title: Am J Epidemiol doi: 10.1093/oxfordjournals.aje.a115853 contributor: fullname: Maclure – ident: 2022010923082746900_ivab220-B9 – volume: 14 start-page: 122 year: 2014 ident: 2022010923082746900_ivab220-B12 article-title: Conditional Poisson models: a flexible alternative to conditional logistic case cross-over analysis publication-title: BMC Med Res Methodol doi: 10.1186/1471-2288-14-122 contributor: fullname: Armstrong – volume: 5 start-page: 60 year: 2015 ident: 2022010923082746900_ivab220-B22 article-title: Physical activity, sleep duration and metabolic health in children fluctuate with the lunar cycle: science behind the myth publication-title: Clin Obes doi: 10.1111/cob.12092 contributor: fullname: Sjodin – volume: 155 start-page: 1525 year: 2013 ident: 2022010923082746900_ivab220-B13 article-title: Impact of the moon on cerebral aneurysm rupture publication-title: Acta Neurochir (Wien) doi: 10.1007/s00701-013-1740-y contributor: fullname: Kamp – volume: 107 start-page: 103 year: 2007 ident: 2022010923082746900_ivab220-B19 article-title: Weight lifting and aortic dissection: more evidence for a connection publication-title: Cardiology doi: 10.1159/000094530 contributor: fullname: Hatzaras – volume: 50 start-page: 1111 year: 2016 ident: 2022010923082746900_ivab220-B29 article-title: The incidence and mortality of acute thoracic aortic dissection: results from a whole nation study publication-title: Eur J Cardiothorac Surg doi: 10.1093/ejcts/ezw235 contributor: fullname: Melvinsdottir – volume-title: Philosophiae naturalis principia mathematica year: 1687 ident: 2022010923082746900_ivab220-B15 doi: 10.5479/sil.52126.39088015628399 contributor: fullname: Newton – volume: 47 start-page: 1163 year: 2017 ident: 2022010923082746900_ivab220-B20 article-title: Acute type A aortic dissection associated with a sporting activity publication-title: Surg Today doi: 10.1007/s00595-017-1492-z contributor: fullname: Itagaki – volume: 24 start-page: 285 year: 2005 ident: 2022010923082746900_ivab220-B11 article-title: Overlap bias in the case-crossover design, with application to air pollution exposures publication-title: Stat Med doi: 10.1002/sim.1889 contributor: fullname: Janes – volume-title: Palaeolithic Timekeepers Looking at the Golden Gate of the Ecliptic; The Lunar Cycle and the Pleiades in the Cave of La-Tête-du-lion (Ardèche, France)—21,000 BP. 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OBJECTIVES
Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons... Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that... OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the... |
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| SubjectTerms | Aneurysm, Dissecting - diagnostic imaging Aneurysm, Dissecting - epidemiology Aneurysm, Dissecting - surgery Cardiac and Cardiovascular Systems Clinical Medicine Cross-Over Studies Dissection of the aorta Humans Incidence Kardiologi Kirurgi Klinisk medicin Medical and Health Sciences Medicin och hälsovetenskap Moon Retrospective Studies Risk Surgery |
| Title | Once after a full moon: acute type A aortic dissection and lunar phases |
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