Johnson N A, Stirling Erb, Alexander M, Dias J J
University Hospitals of Leicester NHS Trust, UK.
Ann R Coll Surg Engl. 2020 May;102(5):348-354. doi: 10.1308/rcsann.2020.0030. Epub 2020 Apr 1.
Predicting when fracture incidence will rise assists in healthcare planning and delivery of preventative strategies. The aim of this study was to investigate the relationship between temperature and the incidence of hip and wrist fractures.
Data for adults presenting to our unit with a hip or wrist fracture over a seven and eight-year period respectively were analysed. Incidence rates were calculated and compared with meteorological records. A Poisson regression model was used to quantify the relationship between temperature and fracture rate.
During the respective study periods, 8,380 patients presented with wrist fractures and 5,279 patients were admitted with hip fractures. All women (≥50 years: <0.001; <50 years: <0.001) and men aged ≥50 years (=0.046) demonstrated an increased wrist fracture rate with reduced temperature. Men aged <50 years also had an increased wrist fracture rate with increased temperature (<0.001).The hip fracture rate was highest in women aged ≥50 years but was not associated with temperature (=0.22). In men aged ≥50 years, there was a significant relationship between reduced temperature and increased fracture rate (<0.001).
Fragility fracture of the wrist is associated with temperature. Compared with an average summer, an additional 840 procedures are performed for wrist fractures during an average winter in our trust with an additional 798 bed days taken up at a cost of £3.2 million. The winter increase seen in male hip fracture incidence requires approximately 888 surgical procedures, with 18,026 bed days, and costs £7.1 million. Hip fracture incidence in older women is not related to temperature.
预测骨折发病率何时会上升有助于医疗保健规划和预防策略的实施。本研究的目的是调查温度与髋部和腕部骨折发病率之间的关系。
分析了分别在七年和八年期间到我院就诊的髋部或腕部骨折成人患者的数据。计算发病率并与气象记录进行比较。采用泊松回归模型量化温度与骨折率之间的关系。
在各自的研究期间,8380例患者出现腕部骨折,5279例患者因髋部骨折入院。所有女性(≥50岁:<0.001;<50岁:<0.001)和≥50岁的男性(=0.046)的腕部骨折率均随温度降低而增加。<50岁的男性腕部骨折率也随温度升高而增加(<0.001)。≥50岁女性的髋部骨折率最高,但与温度无关(=0.22)。在≥50岁的男性中,温度降低与骨折率增加之间存在显著关系(<0.001)。
腕部脆性骨折与温度有关。与夏季平均水平相比,在我们信托机构,冬季平均因腕部骨折多进行840例手术,多占用798个住院日,费用为320万英镑。男性髋部骨折发病率在冬季的增加需要约888例外科手术,18026个住院日,费用为710万英镑。老年女性髋部骨折发病率与温度无关。