Giulia Ogliari1, Terence Ong2, Lindsey Marshall3, Opinder Sahota4. 1. Department of Health Care for Older People, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, United Kingdom. Electronic address: Giulia.Ogliari1@nottingham.ac.uk. 2. Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Electronic address: terenceong@doctors.org.uk. 3. Department of Trauma & Orthopaedics, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, United Kingdom. Electronic address: lindsey.marshall@nuh.nhs.uk. 4. Department of Health Care for Older People, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, United Kingdom; Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Derby Road, Nottingham NG7 2UH, United Kingdom; National Institute for Health Research (NIHR, Nottingham Biomedical Research Centre (BRC), Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, United Kingdom. Electronic address: opinder.sahota@nuh.nhs.uk.
Abstract
PURPOSE: To investigate the monthly and seasonal variation in adult osteoporotic fragility fractures and the association with weather. METHODS: 12-year observational study of a UK Fracture Liaison Service (outpatient secondary care setting). Database analyses of the records of adult outpatients aged 50 years and older with fragility fractures. Weather data were obtained from the UK's national Meteorological Office. In the seasonality analyses, we tested for the association between months and seasons (determinants), respectively, and outpatient attendances, by analysis of variance (ANOVA) and Tukey's test. In the meteorological analyses, the determinants were mean temperature, mean daily maximum and minimum temperature, number of days of rain, total rainfall and number of days of frost, per month, respectively. We explored the association of each meteorological variable with outpatient attendances, by regression models. RESULTS: The Fracture Liaison Service recorded 25,454 fragility fractures. We found significant monthly and seasonal variation in attendances for fractures of the: radius or ulna; humerus; ankle, foot, tibia or fibula (ANOVA, all p-values <0.05). Fractures of the radius or ulna and humerus peaked in December and winter. Fractures of the ankle, foot, tibia or fibula peaked in July, August and summer. U-shaped associations were showed between each temperature parameter and fractures. Days of frost were directly associated with fractures of the radius or ulna (p-value <0.001) and humerus (p-value 0.002). CONCLUSION: Different types of fragility fractures present different seasonal patterns. Weather may modulate their seasonality and consequent healthcare utilisation.
PURPOSE: To investigate the monthly and seasonal variation in adult osteoporotic fragility fractures and the association with weather. METHODS: 12-year observational study of a UK Fracture Liaison Service (outpatient secondary care setting). Database analyses of the records of adult outpatients aged 50 years and older with fragility fractures. Weather data were obtained from the UK's national Meteorological Office. In the seasonality analyses, we tested for the association between months and seasons (determinants), respectively, and outpatient attendances, by analysis of variance (ANOVA) and Tukey's test. In the meteorological analyses, the determinants were mean temperature, mean daily maximum and minimum temperature, number of days of rain, total rainfall and number of days of frost, per month, respectively. We explored the association of each meteorological variable with outpatient attendances, by regression models. RESULTS: The Fracture Liaison Service recorded 25,454 fragility fractures. We found significant monthly and seasonal variation in attendances for fractures of the: radius or ulna; humerus; ankle, foot, tibia or fibula (ANOVA, all p-values <0.05). Fractures of the radius or ulna and humerus peaked in December and winter. Fractures of the ankle, foot, tibia or fibula peaked in July, August and summer. U-shaped associations were showed between each temperature parameter and fractures. Days of frost were directly associated with fractures of the radius or ulna (p-value <0.001) and humerus (p-value 0.002). CONCLUSION: Different types of fragility fractures present different seasonal patterns. Weather may modulate their seasonality and consequent healthcare utilisation.
Authors: Kinga Jedynasty; Mariusz Zięba; Jakub Adamski; Marcin Czech; Piotr Głuszko; Dariusz Gozdowski; Agnieszka Szypowska; Andrzej Śliwczyński; Magdalena Walicka; Edward Franek Journal: Int J Environ Res Public Health Date: 2022-08-02 Impact factor: 4.614