Weather conditions and their effect on seasonality of incident osteoporotic hip fracture
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.
KeywordsHip fracture Weather Climatological variables Seasonality Osteoporosis Spain
Basic minimum data set
Conjunto Mínimo Básico de Datos
International Classification of Diseases, 9th Clinical Modification
State Meteorological Station
day of year
Generalized additive models
- 95% CI
95% confidence interval
Incidence rate ratio
We thank the staff of State Meteorological Station (AEMET) for contributing with the meteorological data and their contribution in the discussion of the results.
RM conceived the study, developed study methods, and prepared the study data. EPF performed the analyses. MLDR advised on the analysis of the data. NCV, AGV, OG, and JQ reviewed the paper and provided comments and edits. RM and LC wrote the manuscript. All authors have read and approved the manuscript.
Publication fees were provided by Abbvie Lab. The funding bodies played no role in any aspect of the study (study design, data collection, analysis, or interpretation or writing of the manuscript).
Compliance with ethical standards
Conflict of interest
Ethics approval and consent to participate
This study has been approved by the Ethics Committee of the Alcorcón Foundation University Hospital.
Availability of data and materials
The study was performed using publicly available data as described in the text. The datasets used and analyzed during the current study are available from the original sources or from the corresponding author on reasonable request.
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