Master Plan of Musculoskeletal Diseases, Department of Health, C/Travessera de les Corts, 131-159, 08028, Barcelona, Catalonia, Spain.
Rheumatology Department, Hospital General de Granollers, Granollers, Spain.
Calcif Tissue Int. 2024 Apr;114(4):326-339. doi: 10.1007/s00223-024-01182-8. Epub 2024 Feb 10.
To describe the secular trend and seasonality of the incidence of hip fracture (HF) and its relationship with climatic variables during the period 2010-2019 in Catalonia in people aged ≥ 65 years. The results were analyzed by sex, age groups (65-74, 75-84, and ≥ 85), and types of fracture (extracapsular and intracapsular). Data on sex, age, type of fracture, year, and month of hospitalization of patients admitted with a diagnosis of HF between January 1, 2010 and December 31, 2019 were collected. Crude and standardized HF incidence (HFi) rates were obtained. Data on the monthly mean of climatological variables (temperature, insolation, icy days, rain, relative humidity, atmospheric pressure, and wind force) were obtained from the network of meteorological stations in Catalonia. Time series analytical statistics were used to identify trends and seasonality. Linear regression and a seasonal autoregressive integrated moving average (ARIMA) were used to analyze the relationship of each climatic parameter with fracture rates. In addition, generalized additive models were used to ascertain the best predictive model. The total number of HF episodes was 90,149 (74.1% in women and 25.9% in men). The total number of HFs increased by 6.4% between 2010 and 2019. The median age (SD) was 84.5 (7.14) and 54% of patients were ≥ 85 years of age. Extracapsular fractures were the most common (55%). The standardized incidence rates decreased from 728.1/100,000 (95% CI 738.6-769.3) to 624.5/100,000 (95% CI 648.7-677.0), which represents a decrease of 14.2% (p < 0.05). The decline was greater at older ages. There were seasonal variations, with higher incidences in autumn (27.2%) and winter (25.7%) and lower rates in summer (23.5%) and spring (23.6%). Seasonality was more pronounced in elderly people and men. In the bivariate regression analysis, high temperatures and greater insolation were negatively associated with the HF rate, while the number of icy days, rainy days, and high relative humidity were associated with a higher incidence of fractures in all age groups and sexes. In the regression analysis using the seasonal ARIMA model, only insolation had a consistently significant association with overall HFi, after adjusting by trend and other climatic parameters. While the global number of HFs grew in Catalonia due to increases in the elderly population, the standardized HF rate decreased during the years 2010-2019. There was a seasonal trend, with predominance in the cold months and correlations with climatic parameters, especially with insolation.
描述 2010-2019 年期间加泰罗尼亚地区≥65 岁人群髋部骨折（HF）的发病率的季节性和季节性趋势及其与气候变量的关系。通过性别、年龄组（65-74、75-84 和≥85）和骨折类型（囊外和囊内）对结果进行了分析。收集了 2010 年 1 月 1 日至 2019 年 12 月 31 日期间因 HF 住院诊断的患者的性别、年龄、骨折类型、年份和月份住院数据。获得了未调整和标准化的 HF 发病率（HFi）率。从加泰罗尼亚气象站网络获取了每月平均气候变量（温度、光照、结冰天数、降雨、相对湿度、大气压和风力）的数据。使用时间序列分析统计数据来识别趋势和季节性。线性回归和季节性自回归综合移动平均（ARIMA）用于分析每个气候参数与骨折率的关系。此外，还使用广义加性模型来确定最佳预测模型。HF 发作总数为 90149 例（女性占 74.1%，男性占 25.9%）。2010 年至 2019 年间，HF 总数增加了 6.4%。中位数年龄（SD）为 84.5（7.14），54%的患者≥85 岁。囊外骨折最为常见（55%）。标准化发病率从 728.1/100,000（95%CI 738.6-769.3）降至 624.5/100,000（95%CI 648.7-677.0），下降了 14.2%（p<0.05）。年龄较大的降幅更大。存在季节性变化，秋季（27.2%）和冬季（25.7%）的发病率较高，夏季（23.5%）和春季（23.6%）的发病率较低。在老年人和男性中，季节性更为明显。在双变量回归分析中，高温和光照强度与 HF 率呈负相关，而结冰天数、降雨天数和高相对湿度与所有年龄组和性别的骨折发生率较高相关。在使用季节性 ARIMA 模型进行的回归分析中，仅光照强度在调整趋势和其他气候参数后与整体 HFi 始终存在显著关联。虽然由于老年人口的增加，加泰罗尼亚的全球 HF 病例数有所增加，但在 2010-2019 年期间，标准化 HF 率有所下降。存在季节性趋势，在寒冷月份占主导地位，并且与气候参数相关，尤其是与光照强度相关。
