Department of Rheumatology, Hospital Universitario Fundación Alcorcón, C/ Budapest no 1., Alcorcón, 28923, Madrid, Spain.
Centro de Salud La Rivota (Alcorcón), Madrid, Spain.
Arch Osteoporos. 2018 Mar 15;13(1):28. doi: 10.1007/s11657-018-0438-4.
Our aim was to analyze the seasonality and the effect of weather conditions on the incidence of osteoporotic hip fracture in a Southern European region.
The objective of this work is to evaluate seasonality and the effect of weather conditions on the incidence of osteoporotic hip fracture in a Southern European region.
This retrospective cohort study included all patients admitted to Alcorcón Foundation University Hospital with a diagnosis of osteoporotic hip fracture between the years 1999 and 2015. In a time series analysis, we examined the association between hip fracture incidence and different weather conditions and seasonality using general additive models (with Poisson distribution). The incidence rate ratio (IRR) crude and adjusted by season was estimated for all parameters. Hip incidence was further analyzed by sex and age (below or over 75) subgroups.
Four thousand two hundred seventy-one patients with an osteoporotic hip fracture were included (79% females, mean age 83.8). Season fracture rate was significantly higher in fall and winter (67.06 and 64.41 fractures/season) compared to summer and spring (59.71 and 60.06; p < 0,001). Hip fracture incidence was 15% greater in autumn and winter than in spring and summer. Fog [IRR 1.15 (95% CI: 1.003-1.33)], atmospheric pressure (per 100 mb) [IRR 1.05 (95% CI: 1.004-1.114)], and frost [IRR 1.15 (95% CI: 1.03-1.30)] were significantly associated with increased hip fracture. Haze [IRR 1.10 (95% CI: 0.99-1.23)] showed a trend without statistical significance. Daily average temperature (per 5 °C) [IRR 0.98 (95% CI: 0.957-0.996)], rain (per 10 ml) [IRR 0.99 (95% CI: 0.981-1.0)], wind speed [IRR = 0.952, (95% CI: 0.907-0.998)], and daily ultraviolet radiation (per 100 joules) [IRR 0.998 (95% CI: 0.996-1.0)] were negatively associated with fracture. After adjusting by season and trend, all these associations disappear.
In this Southern region, hip fracture incidence exhibits a seasonal pattern different from those communicated in Northern regions. There is short-term association with different weather conditions that partly explain this seasonal pattern.
分析南欧地区骨质疏松性髋部骨折的季节性和天气条件对其发病的影响。
本研究旨在评估南欧地区骨质疏松性髋部骨折的季节性和天气条件对其发病的影响。
本回顾性队列研究纳入了 1999 年至 2015 年期间在阿尔科孔基金会大学医院因骨质疏松性髋部骨折入院的所有患者。我们采用广义加性模型（泊松分布）分析了髋部骨折发病率与不同天气条件和季节性之间的关联。对于所有参数，我们均估计了粗发病率比（IRR）和季节调整后的发病率比。进一步按性别和年龄（75 岁以下或以上）亚组分析髋部骨折的发生率。
本研究共纳入了 4271 例骨质疏松性髋部骨折患者（79%为女性，平均年龄 83.8 岁）。与夏季和春季（59.71 和 60.06 个/季）相比，秋季和冬季的骨折发生率显著更高（分别为 67.06 和 64.41 个/季；p<0.001）。与春季和夏季相比，秋季和冬季髋部骨折的发生率分别高出 15%。雾（IRR 1.15[95%CI：1.003-1.33]）、大气压（每 100mb）[IRR 1.05（95%CI：1.004-1.114）]和霜（IRR 1.15[95%CI：1.03-1.30]）与髋部骨折的增加显著相关。霾（IRR 1.10[95%CI：0.99-1.23]）显示出无统计学意义的趋势。日平均温度（每升高 5°C）[IRR 0.98（95%CI：0.957-0.996）]、降雨量（每增加 10ml）[IRR 0.99（95%CI：0.981-1.0]）、风速[IRR=0.952（95%CI：0.907-0.998）]和日紫外线辐射（每增加 100 焦耳）[IRR 0.998（95%CI：0.996-1.0]）与骨折呈负相关。在按季节和趋势调整后，所有这些关联均消失。
在这个南部地区，髋部骨折的发病率呈季节性模式，与北部地区报道的模式不同。与不同的天气条件存在短期关联，部分解释了这种季节性模式。
