Ann Arbor, Mich. From the Department of Surgery, Section of Plastic Surgery, University of Michigan Health System; the Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School; and the Center for Statistical Consultation and Research, University of Michigan.
Plast Reconstr Surg. 2014 Feb;133(2):321-332. doi: 10.1097/01.prs.0000436796.74305.38.
Distal radius fractures are costly and debilitating injuries, especially for the elderly. These fractures often occur from falls and commonly occur outdoors. Inclement weather may increase the risk of fall-related injuries. Small studies have reported an increased risk of distal radius fracture caused by inclement winter weather; larger studies are lacking.
The authors analyzed a sample of 2007 Medicare claims for distal radius fracture. Weather data were collected for the date and location of each distal radius fracture in the authors' analysis cohort. A novel slipperiness score was used as a measure of the severity of slippery outdoor conditions. Negative binomial regression models evaluated the correlation between slipperiness and distal radius fracture occurrence.
Risk of distal radius fracture was higher in winter months (incidence rate ratio, 1.2; p < 0.001). Days with average temperature less than or equal to 32°F (incidence rate ratio, 1.36; p < 0.001), snow/ice on the ground at the start of the day (incidence rate ratio, 1.45; p < 0.001), and freezing rain (incidence rate ratio, 1.24; p = 0.025) all had an increased risk of distal radius fracture. The risk of sustaining a distal radius fracture was increased 21 percent on days with a slipperiness score above 4 (incidence rate ratio, 1.21; p = 0.007). For each increase in slipperiness score above 4, the incidence rate ratio of distal radius fracture increased as well.
Weather events that create slippery walking conditions, often in the winter, result in an increased risk of distal radius fracture in the elderly. This finding can be used to support resource allocation and awareness and prevention campaigns.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, IV.
桡骨远端骨折是一种代价高昂且使人虚弱的损伤，尤其是对于老年人而言。这些骨折通常由跌倒引起，常见于户外。恶劣的天气可能会增加与跌倒相关的损伤风险。一些小型研究报告称，恶劣的冬季天气会增加桡骨远端骨折的风险；但缺乏更大规模的研究。
作者分析了 2007 年 Medicare 对桡骨远端骨折的索赔样本。为作者分析队列中每个桡骨远端骨折的日期和位置收集了天气数据。采用新颖的滑溜度评分作为衡量户外湿滑条件严重程度的指标。使用负二项回归模型评估滑溜度与桡骨远端骨折发生之间的相关性。
冬季月份桡骨远端骨折的风险更高（发病率比，1.2；p < 0.001）。日平均温度等于或低于 32°F（发病率比，1.36；p < 0.001）、开始下雪/结冰（发病率比，1.45；p < 0.001）和冻雨（发病率比，1.24；p = 0.025）的日子骨折风险增加。滑溜度评分高于 4 分时，发生桡骨远端骨折的风险增加 21%（发病率比，1.21；p = 0.007）。滑溜度评分每增加 4 分，桡骨远端骨折的发病率比也会增加。
导致行走湿滑的天气事件（通常在冬季）会增加老年人桡骨远端骨折的风险。这一发现可用于支持资源分配以及意识和预防活动。
临床问题/证据水平：风险，IV。
