Lu Shuai, Liu Xuejiao, Niu Yanlin, Li Feng, Gong Maoqi, Zha Yejun, Chao Qingchen, Lu Bo, Zhang Baichao, Li Ning, Chen Jia, Liu Qiyong, Yuan Rui, Jiang Xieyuan
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China.
Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Beijing 100035, China.
Sci Total Environ. 2023 May 20;874:162583. doi: 10.1016/j.scitotenv.2023.162583. Epub 2023 Mar 3.
Studies on the associations between temperature and osteoporotic fractures (OF) hospitalizations are limited. This study aimed to assess the short-term effect of apparent temperature (AT) on the risk of OF hospitalizations.
This retrospective observational study was conducted in Beijing Jishuitan Hospital from 2004 to 2021. Daily OF hospitalizations, meteorological variables and fine particulate matter were collected. A Poisson generalized linear regression model combined with a distributed lag non-linear model was applied to analyze the lag-exposure-response relationship between AT and the number of OF hospitalizations. Subgroup analysis by gender, age and fracture type was also conducted.
Total daily hospitalization visits for OF during the studied period were 35,595. The exposure-response curve of AT and OF presented a non-linear relationship, with optimum apparent temperature (OAT) at 28.40 °C. Taking OAT as the reference, the cold effect (-10.58 °C, 2.5th percentage) on single lag day had statistical significance from the current day of exposure (RR = 1.18, 95 % CI: 1.08-1.28) to lag 4 day (RR = 1.04, 95 % CI: 1.01-1.08), while the cumulative cold effect increased the risk of OF hospitalization visits from lag 0 to 14 days, with the maximum RR over lag 0-14 days (RR = 1.84, 95 % CI: 1.21-2.79). There were no significant risks of OF hospitalizations for warm effects (32.53 °C, 97.5th percentage) on single or cumulative lag days. The cold effect might be more evident among females, patients aged 80 years or older, and patients with hip fractures.
Exposure to cold temperatures is associated with an increased risk of OF hospitalizations. Females, patients aged 80 years or older and patients with hip fractures might be more vulnerable to the cold effect of AT.
关于温度与骨质疏松性骨折(OF)住院之间关联的研究有限。本研究旨在评估体感温度(AT)对OF住院风险的短期影响。
本回顾性观察性研究于2004年至2021年在北京积水潭医院进行。收集每日OF住院情况、气象变量和细颗粒物。应用泊松广义线性回归模型结合分布滞后非线性模型分析AT与OF住院人数之间的滞后暴露-反应关系。还按性别、年龄和骨折类型进行了亚组分析。
研究期间OF的每日总住院人次为35,595。AT与OF的暴露-反应曲线呈非线性关系,最佳体感温度(OAT)为28.40℃。以OAT为参照,在单个滞后日,寒冷效应(-10.58℃,第2.5百分位数)从暴露当日(RR = 1.18,95%CI:1.08 - 1.28)至滞后4天(RR = 1.04,95%CI:1.01 - 1.08)具有统计学意义,而累积寒冷效应使OF住院人次风险从滞后0天至14天增加,滞后0 - 14天的最大RR为(RR = 1.84,95%CI:1.21 - 2.79)。在单个或累积滞后日,温暖效应(32.53℃,第97.5百分位数)对OF住院无显著风险。寒冷效应在女性、80岁及以上患者和髋部骨折患者中可能更明显。
暴露于低温与OF住院风险增加有关。女性、80岁及以上患者和髋部骨折患者可能更容易受到AT寒冷效应的影响。