Horita Ana Beatriz I, Vargas Silva Rafael, Ramos Dos Santos Tulio M, Almeida Lima Caio R
Orthopedics and Traumatology, Pontifícia Universidade Católica de São Paulo, Sorocaba, BRA.
Cureus. 2024 Aug 15;16(8):e66954. doi: 10.7759/cureus.66954. eCollection 2024 Aug.
Femur fractures represent a significant public health concern for individuals over 60 years of age. In Brazil, the incidence of these fractures has shown a rising trend in line with population aging. Besides intrinsic risk factors like osteoporosis, seasonal and climatic variables have been suggested to significantly influence the occurrence of these fractures.
Epidemiological data were sourced from the Hospital Information System of the Unified Health System (SIH-SUS) using the TABNET tool provided by the Department of Informatics of the Unified Health System (DATASUS). Information on hospital admissions for femur fractures in individuals over 60 years, categorized by diagnosis, region, and month, was collected from 2008 to 2023. Climatic data were obtained from the Brazilian National Institute of Meteorology (INMET) for the period from 1991 to 2020. Monthly average temperatures were compared with epidemiological data and analyzed to uncover correlations using ANOVA and Tukey's honestly significant difference (HSD) test.
During Brazil's winter months (June to August: 22.8 to 23.5º Celsius), average temperatures are at their lowest. This period also coincides with the peak incidence of femur fractures among the elderly. ANOVA revealed significant differences in fracture rates across various temperature ranges. Subsequent analysis using Tukey's HSD test identified significant differences between temperature ranges of 22-23°C and 25-26°C, as well as 23-24°C and 25-26°C. These results indicate that lower temperatures are associated with a higher incidence of femur fractures among the elderly.
The analysis reveals a seasonal pattern in fracture incidence among older adults, with a notable increase during the colder months. To mitigate this risk, it is recommended to implement strategies such as heightened surveillance during colder months, targeted fall prevention measures, and effective osteoporosis management. These interventions aim to reduce the incidence of fractures in this vulnerable population.
股骨骨折是60岁以上人群面临的重大公共卫生问题。在巴西，随着人口老龄化，这些骨折的发病率呈上升趋势。除了骨质疏松等内在风险因素外，季节和气候变量也被认为会显著影响这些骨折的发生。
利用统一卫生系统信息学部（DATASUS）提供的TABNET工具，从统一卫生系统（SIH-SUS）的医院信息系统获取流行病学数据。收集2008年至2023年60岁以上因股骨骨折住院的患者信息，按诊断、地区和月份进行分类。气候数据来自巴西国家气象研究所（INMET）1991年至2020年期间的数据。将月平均气温与流行病学数据进行比较，并使用方差分析（ANOVA）和图基氏真实显著差异（HSD）检验进行分析，以揭示相关性。
在巴西的冬季（6月至8月：22.8至23.5摄氏度），平均气温最低。这一时期也恰好是老年人股骨骨折发病率的高峰期。方差分析显示，不同温度范围的骨折发生率存在显著差异。随后使用图基氏HSD检验进行的分析确定，22-23°C与25-26°C以及23-24°C与25-26°C的温度范围之间存在显著差异。这些结果表明，较低的温度与老年人股骨骨折的较高发病率相关。
分析揭示了老年人骨折发生率的季节性模式，在较冷的月份显著增加。为降低这种风险，建议采取一些策略，如在较冷月份加强监测、针对性的预防跌倒措施以及有效的骨质疏松症管理。这些干预措施旨在降低这一脆弱人群的骨折发生率。
