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Ecarnot F, Thiyagarajan JA, Barbagallo M, Barratt J, Constantinescu S, Elkayam O, Ferrucci L, Hiligsmann M, Kapetanovic M, Macchia F, Michel JP, Migliore A, Pilotto A, Sieber C, Strangfeld A, Veronese N, Vetrano DL, Maggi S, Rizzoli R. Musculoskeletal diseases, infections and vaccines: state of the art, research perspectives and educational needs. Aging Clin Exp Res 2025; 37:46. [PMID: 39985736 PMCID: PMC11846730 DOI: 10.1007/s40520-025-02940-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Accepted: 01/28/2025] [Indexed: 02/24/2025]
Abstract
Musculoskeletal disorders are a significant public health burden concern, projected to increase in the coming decades, and will substantially contribute to the rising prevalence of functional impairment, frailty and disability in a growing global population. Since persons with musculoskeletal disorders tend to have immune dysfunction, inflammation or be taking immunosuppressive medication, prevention of vaccine-preventable diseases (VPDs) in this group is particularly important. The European Interdisciplinary Council for Aging (EICA) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) jointly convened a 2-day in-person and virtual meeting on 26-27 September 2023, to review the state of the evidence on the link between musculoskeletal diseases, infections and vaccines. We present here the Executive Summary of the proceedings of this meeting. We review the importance of physical activity in preventing or mitigating both musculoskeletal diseases and risk of infection. We summarize current knowledge of the impact of common VPDs on the development and progression of musculoskeletal diseases, and the role of selected vaccines in preventing onset and worsening of frailty and disability in these individuals. This report summarizes the evidence presented at the two-day meeting, highlighting the need to raise awareness among scientists, healthcare professionals, decision-makers, civil society and the general public about the long-term sequelae of VPDs, with focus on the health status of older patients with musculoskeletal diseases.
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Affiliation(s)
- Fiona Ecarnot
- SINERGIES, University of Franche-Comté, Besançon, 25000, France.
- Department of Cardiology, University Hospital Besançon, Besançon, 25000, France.
| | - Jotheeswaran Amuthavalli Thiyagarajan
- Department of Maternal, Responsible Officer for Bone Health and Ageing Initiative, Ageing and Health Unit, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Mario Barbagallo
- Department of Internal Medicine and Geriatrics, Geriatric Unit, University of Palermo, Via del Vespro 141, Palermo, 90127, Italy
| | - Jane Barratt
- International Federation on Ageing, Toronto, Canada
| | | | - Ori Elkayam
- Department of Rheumatology, Tel Aviv Medical Center, Tel Aviv Medical Center and the "Sackler" Faculty of Medicine, Tel Aviv, Israel
| | - Luigi Ferrucci
- Intramural Research Program of the National Institute on Aging, Baltimore, MD, USA
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Meliha Kapetanovic
- Institution of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
| | | | | | - Alberto Migliore
- Rheumatology Unit, San Pietro Fatebenefratelli Hospital, Rome, 00189, Italy
| | - Alberto Pilotto
- Department of Geriatric Care, Neurology and Rehabilitation, E. O. Galliera Hospitals, Genoa, Italy
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Cornel Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander University Erlangen-Nürnberg, Solna, Sweden
- County Hospital Winterthur, Winterthur, Sweden
| | - Anja Strangfeld
- Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nicola Veronese
- Saint Camillus International University of Health Sciences, Rome, Italy
| | - Davide Liborio Vetrano
- Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy.
| | - René Rizzoli
- Faculty of Medicine and Geneva University Hospitals, Geneva, Switzerland
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Chiang MH, Kuo YJ, Huang SW, Tran DNA, Chuang TY, Chen YP, Lin CY. A Higher Charlson Comorbidity Index Is a Risk Factor for Hip Fracture in Older Adults During Low-Temperature Periods: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1962. [PMID: 39768843 PMCID: PMC11677170 DOI: 10.3390/medicina60121962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 11/21/2024] [Accepted: 11/25/2024] [Indexed: 01/11/2025]
Abstract
Background and Objectives: The incidence of hip fractures is increasing, and there have been reports linking cold weather to a higher risk of fractures. This study aimed to evaluate clinical variables in hip fracture patients who may predispose them to such fractures under different temperatures. Materials and Methods: This is a cross-sectional study conducted at a single medical center, enrolling older adults (≥60 years) who had experienced a hip fracture. Comprehensive clinical histories and detailed information regarding each patient's hip fracture were obtained. All meteorological data were extracted from the Taiwan Central Weather Bureau database. Multiple clinical parameters that may have a close connection with the temperature at which the hip fracture occurred were screened. Statistical analysis involved using the Pearson correlation test or the independent Student's t test, followed by generalized estimating equation analysis. Results: The cohort comprised 506 older adults with hip fractures. Initial univariate analysis revealed that a history of past cerebrovascular diseases, Charlson Comorbidity Index, patient age, and preinjury Barthel Index were significantly related to the temperature at which the hip fractures occurred. The generalized estimating equation analysis indicated that only the Charlson Comorbidity Index had a considerably inverse association with temperature. This finding suggests that for older adults with a higher Charlson Comorbidity Index, hip fractures tend to occur at lower temperatures and vice versa. Conclusions: Comorbidities are the only clinical concern that predisposes older adults to hip fractures under colder temperatures. This epidemiological finding could guide future patient education and hip fracture prevention programs.
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Affiliation(s)
- Ming-Hsiu Chiang
- Department of General Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
| | - Yi-Jie Kuo
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; (Y.-J.K.); (T.-Y.C.)
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Shu-Wei Huang
- Department of Applied Science, National Taitung University, Taitung 950, Taiwan;
| | - Duy Nguyen Anh Tran
- The International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam
| | - Tai-Yuan Chuang
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; (Y.-J.K.); (T.-Y.C.)
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Yu-Pin Chen
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; (Y.-J.K.); (T.-Y.C.)
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
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Mitsutake S, Lystad RP, Long JC, Braithwaite J, Mitchell R. Impact of COVID-19 public health restrictions on fall-related hip fracture hospitalizations: An interrupted time series analysis. Bone 2024; 188:117237. [PMID: 39159886 DOI: 10.1016/j.bone.2024.117237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 08/11/2024] [Accepted: 08/13/2024] [Indexed: 08/21/2024]
Abstract
PURPOSE There is limited evidence regarding the impact of public health restrictions on hip fracture hospitalization by place of fracture occurrence. This study aimed to examine the impact of COVID-19 public health restrictions on fall-related hip fracture hospitalization rates by place of occurrence. METHODS This retrospective cohort study was conducted using hospitalization data in New South Wales, Australia, between January 2014 and June 2022. Older adults aged ≥65 years admitted to hospital following a fall-related hip fracture. An interrupted time-series analysis using autoregressive integrated moving average models evaluated the impact of public health restrictions on fall-related hip fracture hospitalization by place of fracture occurrence (home/residence, residential aged care facility (RACF), or away from usual residence). RESULTS The mean observed fall-related hip fracture hospitalization rate during COVID-19 public health restrictions (36.3 per 100,000 people per month) was 13.4 % lower than the forecasted rate (41.1 per 100,000 people per month). The mean observed hospitalization rates for fall-related hip fractures at home/residence, at a RACF, and away from the usual residence were 3.8 %, 18.5 %, and 40.1 % lower than the forecasted rates, respectively. Level changes in the fall-related hip fracture hospitalization rates at RACFs and away from usual residences were -0.9 per 100,000 people per month (95 % CI -1.6 to -0.2) and -1.7 per 100,000 people per month (95 % CI -2.5 to -0.9), respectively. CONCLUSIONS There was a decline in fall-related hip fracture hospitalization rates among older adults, where the fracture occurred at RACFs and away from a person's usual residence during COVID-19 public health restrictions.
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Affiliation(s)
- Seigo Mitsutake
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, NSW 2109, Australia; Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, NSW 2109, Australia
| | - Janet C Long
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, NSW 2109, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, NSW 2109, Australia
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Macquarie University, NSW 2109, Australia
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Horita ABI, Vargas Silva R, Ramos Dos Santos TM, Almeida Lima CR. Evaluation of Seasonal and Climatic Variations Associated With Femoral Fracture Incidence Among the Elderly Population in Brazil. Cureus 2024; 16:e66954. [PMID: 39280528 PMCID: PMC11401615 DOI: 10.7759/cureus.66954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2024] [Indexed: 09/18/2024] Open
Abstract
INTRODUCTION 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. METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Ana Beatriz I Horita
- Orthopedics and Traumatology, Pontifícia Universidade Católica de São Paulo, Sorocaba, BRA
| | - Rafael Vargas Silva
- Orthopedics and Traumatology, Pontifícia Universidade Católica de São Paulo, Sorocaba, BRA
| | | | - Caio R Almeida Lima
- Orthopedics and Traumatology, Pontifícia Universidade Católica de São Paulo, Sorocaba, BRA
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Ren Y, Li J, Yang J, Hu L, Xu Z, Fu R, Wu K, Guo M, Hu M, Ran L, Li X, Qiu H, Liao L, Zhang M, Luo Y, Zhou S, Ding F. Meteorological parameters and hospital-acquired falls-A multicenter retrospective study based on 10 years of adverse events reporting system data. Heliyon 2024; 10:e34193. [PMID: 39071631 PMCID: PMC11279767 DOI: 10.1016/j.heliyon.2024.e34193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 07/30/2024] Open
Abstract
Objective and rationale Hospital-acquired falls are common and serious adverse events in medical institutions, with high incidence and injury rates. Studying the occurrence patterns of hospital-acquired falls is important for preventing falls in hospitalized patients. However, the effect of meteorological factors on hospital-acquired falls has not been elucidated. Therefore, this study explored the impact of meteorological parameters on hospital-acquired falls in Chongqing, China, and provided new ideas for the clinical prevention of falls in patients. Methods Correlation analysis and distributed lag nonlinear models were employed to analyze the relationship between 3890 cases of hospital-acquired falls and meteorological data in 13 hospitals in 11 districts and counties in Chongqing from January 2013 to April 2023. Results The number of hospital-acquired falls demonstrated a nonlinear correlation with the daily average relative humidity and negatively correlated with sunshine duration; however, temperature, air pressure, and wind speed were not correlated. Compared to the reference humidity (87 %), the immediate effects of daily average relative humidity (65-68 % and 90-97 %) increased the risk of hospital-acquired falls on the same day (relative risk [RR]:1.027-1.243). When the daily average relative humidity was 95-97 %, lags of 0-1 d and 8-12 d had greater effects on falls (RR:1.073-1.243). The daily average relative humidities of 62-74 % and 91-97 % were statistically significant at cumulative relative risk (CRR)of 4, 7, 10, and 14 d with a cumulative lag (CRR: 1.111-4.277). On sex and age stratification, the lag and cumulative effects of relative humidity more significantly impacted falls in women and patients aged ≥65 years. Conclusion Daily average relative humidity had a nonlinear correlation and lag effect on hospital-acquired falls; therefore, medical institutions should pay attention to the effect of relative humidity on hospital-acquired falls in patients, especially old and female patients.
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Affiliation(s)
- Yuanyuan Ren
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jinyan Li
- Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jun Yang
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Lei Hu
- Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zhihui Xu
- Nursing Department, Hechuan District People's Hospital of Chongqing, Chongqing, 401533, China
| | - Rongjuan Fu
- Nursing Department, Dianjiang People's Hospital of Chongqing, Chongqing, 408300, China
| | - Kaihui Wu
- Nursing Department, Nanchuan District People's Hospital of Chongqing, Chongqing, 408400, China
| | - Min Guo
- Nursing Department, The 13th People's Hospital of Chongqing, Chongqing, 400050, China
| | - Mei Hu
- Nursing Department, Chongqing University Three Gorges Hospital, Chongqing, 404100, China
| | - Liu Ran
- Department of Endocrinology, Changshou District People's Hospital of Chongqing, Chongqing, 401220, China
| | - Xia Li
- Nursing Department, Qijiang District People's Hospital, Chongqing, 401420, China
| | - Huicheng Qiu
- Nursing Department, Liangping District People's Hospital, Chongqing, 405200, China
| | - Lianmei Liao
- Nursing Department, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401121, China
| | - Mengmeng Zhang
- Nursing Department, Banan District People's Hospital of Chongqing, Chongqing, 401320, China
| | - Yetao Luo
- Department of Nosocomial Infection Control, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, China
| | - Sumei Zhou
- Emergency Department, The First Affiliated Hospital of Chongqing Medical University, 400016, China
| | - Fu Ding
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
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Hassanabadi N, Berger C, Papaioannou A, Cheung AM, Rahme E, Leslie WD, Goltzman D, Morin SN. Geographic variation in bone mineral density and prevalent fractures in the Canadian longitudinal study on aging. Osteoporos Int 2024; 35:599-611. [PMID: 38040857 DOI: 10.1007/s00198-023-06975-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
Awareness of the prevalence of osteoporosis and fractures across jurisdictions can guide the development of local preventive programs and healthcare policies. We observed geographical variations in total hip bone mineral density and in the prevalence of major osteoporotic fractures across Canadian provinces, which persisted after adjusting for important covariates. PURPOSE We aimed to describe sex-specific total hip bone mineral density (aBMD) and prevalent major osteoporotic fractures (MOF) variation between Canadian provinces. METHODS We used baseline data from 21,227 Canadians (10,716 women, 10,511 men) aged 50-85 years in the Canadian Longitudinal Study on Aging (CLSA; baseline: 2012-2015). Linear and logistic regression models were used to examine associations between province of residence and total hip aBMD and self-reported MOF, stratified by sex. CLSA sampling weights were used to generate the prevalence and regression estimates. RESULTS The mean (SD) age of participants was 63.9 (9.1) years. The mean body mass index (kg/m2) was lowest in British Columbia (27.4 [5.0]) and highest in Newfoundland and Labrador (28.8 [5.3]). Women and men from British Columbia had the lowest mean total hip aBMD and the lowest prevalence of MOF. Alberta had the highest proportion of participants reporting recent falls (12.0%), and Manitoba (8.4%) the fewest (p-value=0.002). Linear regression analyses demonstrated significant differences in total hip aBMD: women and men from British Columbia and Alberta, and women from Manitoba and Nova Scotia had lower adjusted total hip aBMD than Ontario (p-values<0.02). Adjusted odds ratios (95% confidence intervals, CI) for prevalent MOF were significantly lower in women from British Columbia (0.47 [95% CI: 0.32; 0.69]) and Quebec (0.68 [95% CI: 0.48; 0.97]) and in men from British Columbia (0.40 [95% CI:0.22; 0.71]) compared to Ontario (p-values<0.03). Results were similar when adjusting for physical performance measures and when restricting the analyses to participants who reported White race/ethnicity. CONCLUSION Geographical variations in total hip aBMD and in the prevalence of MOF between provinces persisted after adjusting for important covariates which suggests an association with unmeasured individual and environmental factors.
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Affiliation(s)
- N Hassanabadi
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - C Berger
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - A Papaioannou
- Department of Medicine, McMaster University, Hamilton, Canada
| | - A M Cheung
- Department of Medicine, University of Toronto, Toronto, Canada
| | - E Rahme
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - W D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, Canada
| | - D Goltzman
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - S N Morin
- Department of Medicine, McGill University, Montreal, Canada.
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada.
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Surís X, Rodríguez C, Llargués E, Pueyo-Sánchez MJ, Larrosa M. Trend and Seasonality of Hip Fractures in Catalonia, Spain: Exploring the Influence of Climate. Calcif Tissue Int 2024; 114:326-339. [PMID: 38340169 PMCID: PMC10957628 DOI: 10.1007/s00223-024-01182-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/30/2023] [Indexed: 02/12/2024]
Abstract
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.
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Affiliation(s)
- Xavier Surís
- 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.
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain.
| | - Clara Rodríguez
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Esteve Llargués
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain
- Internal Medicine Department, Hospital General de Granollers, Granollers, Spain
| | - Maria J Pueyo-Sánchez
- Assistance and Participation Area. La Unió, Association of Health and Social Entities, Barcelona, Spain
| | - Marta Larrosa
- Master Plan of Musculoskeletal Diseases, Department of Health, C/Travessera de les Corts, 131-159, 08028, Barcelona, Catalonia, Spain
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Lu S, Liu X, Niu Y, Li F, Gong M, Zha Y, Chao Q, Lu B, Zhang B, Li N, Chen J, Liu Q, Yuan R, Jiang X. Short-term effect of apparent temperature on daily hospitalizations for osteoporotic fractures in Beijing, China: A retrospective observational study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 874:162583. [PMID: 36870481 DOI: 10.1016/j.scitotenv.2023.162583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Shuai Lu
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xuejiao Liu
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yanlin Niu
- Beijing Center for Disease Prevention and Control, Institute for Nutrition and Food Hygiene, Beijing 100035, China
| | - Feng Li
- Department of Orthopedics, The Third People's Hospital of Xiao Shan Hangzhou, Hangzhou 311251, China
| | - Maoqi Gong
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yejun Zha
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Qingchen Chao
- China National Climate Center, Beijing 100081, China
| | - Bo Lu
- China National Climate Center, Beijing 100081, China
| | - Baichao Zhang
- China National Climate Center, Beijing 100081, China
| | - Ning Li
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Jia Chen
- Department of Endocrinology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Rui Yuan
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xieyuan Jiang
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China.
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9
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Feng J, Huang J, Li B, Zheng X, Wang J, Wang S, Zhan S, Song C. Association between weather and hip fracture in adults: a nationwide study in China 198 cities. Arch Osteoporos 2023; 18:70. [PMID: 37198358 DOI: 10.1007/s11657-023-01248-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 04/17/2023] [Indexed: 05/19/2023]
Abstract
Hip fractures represent a significant public health issue due to high incidence in aging society. Our study further proved that increased risk for hip fractures in adults is associated with weather conditions. PURPOSE Hip fractures represent a significant public health issue due to high incidence in aging society. Evidence of the short-term effects of weather on the risk of hip fracture is limited and inconsistent. We aimed to examine the associations between weather conditions and daily hospital admissions for hip fracture in adults in China. METHODS A national time-series analysis between 2014 and 2017 was conducted. Data on daily hospital admissions for hip fracture were obtained from the database of Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI). Weather conditions were acquired from the China Meteorological Data Sharing Service Center. Based on a time-stratified case-crossover design, conditional Poisson regression was used to estimate the impact on relative risk (RR) of weather conditions on hospital admissions for hip fracture. RESULTS During the study period, a total of 137,504 hospital admissions for hip fractures were identified. All analyzed weather conditions showed consistent significant associations at lag 0 day for each 10 mm increase in precipitation, 10 m/s in wind speed, and 10°C in temperature, with the RR value being 1.079 (95% CI, 1.074-1.083) for precipitation, 1.404 (95% CI, 1.346-1.465) for wind speed, and 1.558 (95% CI, 1.546-1.570) for temperature. Women were more vulnerable to be affected by precipitation and temperature. CONCLUSION In conclusion, increased risk for hip fractures in adults is associated with weather conditions. The improved understanding of the relationship between weather conditions and hip fractures hospital admission can be useful for resource allocation and provider preparedness.
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Affiliation(s)
- Jingnan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jie Huang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Baohua Li
- Institute of Medical Innovation, Peking University Third Hospital, Beijing, China
| | - Xuanqi Zheng
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Jinxi Wang
- Shanghai Songsheng Business Consulting Co. LTD, Beijing, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
- Institute for Artificial Intelligence, Peking University, Beijing, China
| | - Chunli Song
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.
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10
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Stanley C, Lennon D, Moriarty F, Sheridan GA, Nagle M, Foley A, Moran C, Donnelly M. The association between weather warnings and hip fractures in the Republic of Ireland. Arch Osteoporos 2023; 18:53. [PMID: 37084122 PMCID: PMC10121515 DOI: 10.1007/s11657-023-01243-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
This study examined the relationship between hip fractures and weather warnings with the hypothesis higher rates of fractures occur during warnings. National hip fracture database and weather warning records were utilised. Higher rates of hip fractures were found with severe warnings. This has implications for planning in future severe warnings. BACKGROUND Hip fractures represent a significant burden on the Irish Health system with 3666 in 2020. The Irish National Meteorological Service operates a colour coded warning system. Yellow being least severe, while orange represents weather with capacity to impact individuals in affected areas and red represents advice to protect themselves and property. Previous studies investigated the seasonality of hip fractures, which remains but none have investigated the relationship between weather warnings and rates of hip fractures. The hypothesis was that increasing weather warnings would be associated with increased hip fractures. The aim was to investigate the relationship between weather warnings and hip fractures in the Republic of Ireland. METHODS Comparison of national weather warning archives from 2013 to 2019 to Fracture Database records. Reviews assessed whether fractures occurred on days a weather warning was in place in the individual's local county. A statistical analysis of warning features and their relationship to hip fractures was then performed. Fractures and weather warnings were stratified by county with both a panel and case crossover analysis performed. RESULTS There was a tendency towards increased incidence of hip fractures with weather warnings in adjusted analysis (IRR 1.02; 95%CI 0.99-1.06; p-value 0.123). Orange warnings were associated with a statistically higher incidence of fractures (IRR 1.06; 1.01-1.12; p-value 0.026). In both panel and case crossover analysis, both orange and yellow warnings were associated with fractures. Red warnings were associated with a lower incidence of fracture on day of warning (adjusted incidence rate ratio 0.92; 0.70-1.22; p-value 0.569) but a higher incidence on the following day (adjusted incidence rate ratio 1.14; 0.88-1.46; p-value 0.313). CONCLUSION An increased incidence of hip fractures appears to occur during weather warnings. Consideration should be given when preparing for periods of extreme weather, ensuring sufficiently resources.
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Affiliation(s)
- Ciarán Stanley
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland.
| | - David Lennon
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gerard A Sheridan
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland
| | - Matthew Nagle
- Department of Trauma and Orthopaedics, University Hospital Limerick, Limerick, Ireland
| | - Alexandra Foley
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland
| | - Conor Moran
- Department of Trauma and Orthopaedics, University Hospital Limerick, Limerick, Ireland
| | - Michael Donnelly
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland
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11
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Adami G, Olivi P, Pontalti M, Benini C, Ramazzini L, Magnan B, Bertoldo E, Gatti D, Fassio A, Rossini M, Negri S. Association between acute exposure to environmental air pollution and fragility hip fractures. Bone 2023; 167:116619. [PMID: 36442796 DOI: 10.1016/j.bone.2022.116619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/03/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | - Pietro Olivi
- Orthopedic Unit, University of Verona, Verona, Italy.
| | | | | | | | - Bruno Magnan
- Orthopedic Unit, University of Verona, Verona, Italy.
| | | | - Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy.
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona, Italy
| | | | - Stefano Negri
- Orthopedic Unit, University of Verona, Verona, Italy.
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12
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Jawad MU, Delman CM, Campbell ST, Fitzpatrick EP, Soles GLS, Lee MA, Randall RL, Thorpe SW. Traumatic Proximal Femoral Fractures during COVID-19 Pandemic in the US: An ACS NSQIP ® Analysis. J Clin Med 2022; 11:jcm11226778. [PMID: 36431255 PMCID: PMC9697726 DOI: 10.3390/jcm11226778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/06/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022] Open
Abstract
In order to determine the impact of COVID-19 on the treatment and outcomes in patients with proximal femoral fracture’s (PFF), we analyzed a national US sample. This is a retrospective review of American College of Surgery’s (ACS) National Surgical Quality Improvement Program (NSQIP) for patients with proximal femoral fractures. A total of 26,830 and 26,300 patients sustaining PFF and undergoing surgical treatment were sampled during 2019 and 2020, respectively. On multivariable logistic regression, patients were less likely to have ‘presence of non-healing wound’ (p < 0.001), functional status ‘independent’ (p = 0.012), undergo surgical procedures of ‘hemiarthroplasty’(p = 0.002) and ‘ORIF IT, Peritroch, Subtroch with plates and screws’ (p < 0.001) and to be ‘alive at 30-days post-op’ (p = 0.001) in 2020 as compared to 2019. Patients were more likely to have a case status ‘emergent’, ‘loss of ≥10% body weight’, discharge destination of ‘home’ (p < 0.001 for each) or ‘leaving against medical advice’ (p = 0.026), postoperative ‘acute renal failure (ARF)’ (p = 0.011), ‘myocardial infarction (MI)’ (p = 0.006), ‘pulmonary embolism (PE)’ (p = 0.047), and ‘deep venous thrombosis (DVT)’ (p = 0.049) in 2020 as compared to 2019. Patients sustaining PFF and undergoing surgical treatment during pandemic year 2020 differed significantly in preoperative characteristics and 30-day postoperative complications when compared to patients from the previous year.
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Affiliation(s)
- Muhammad Umar Jawad
- Department of Orthopedic Surgery, Good Samaritan Regional Medical Center, Corvallis, OR 97330, USA
| | - Connor M. Delman
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA 95817, USA
| | - Sean T. Campbell
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA 95817, USA
| | - Ellen P. Fitzpatrick
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA 95817, USA
| | - Gillian L. S. Soles
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA 95817, USA
| | - Mark A. Lee
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA 95817, USA
| | - R. Lor Randall
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA 95817, USA
| | - Steven W. Thorpe
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA 95817, USA
- Correspondence:
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13
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Epidemiological characteristics of fractures of spine, hip, proximal humerus and forearm during the haze epidemic period. Injury 2022; 53:3139-3148. [PMID: 35973869 DOI: 10.1016/j.injury.2022.08.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/27/2022] [Accepted: 08/06/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Air pollutants have an impact on the occurrence of spine fractures, hip fractures, proximal humerus fractures and forearm fractures. This study aimed at evaluating the short-term impact of particulate matter with aerodynamic diameters of less than 2.5 µm (PM2.5) on the occurrence of those fractures in Shijiazhuang, Hebei, China. METHODS The daily meteorological, pollution, and fracture data of Shijiazhuang from 2014 to 2019 were collected. Distribution characteristics of fractures were described using descriptive epidemiological methods. The distributed lag nonlinear model (DLNM) was used to reveal the description of those fractures in the exposed and lag dimensions at the same time. Based on gender and age (<18 years old, 18-69 years old and >69 years old), stratified analysis was performed. Sensitivity analysis was performed to ascertain the robustness of the results. RESULTS Between 2014 and 2019, fracture incidences in Shijiazhuang exhibited an overall increasing trend, with an obvious seasonality. PM2.5 was positively related to daily fracture cases and the effects were more obvious in women, adolescents and people of working age. When PM2.5 concentrations increased by one interquartile range (IQR) (70 μg/m3), RR exhibited a unimodal distribution. Its peak appeared on the 16th day of lag (RR=1.005987, 95% CI:1.002472,1.009652), and the RRs were also statistically significant from the 10th to 22nd day of lag. Similarly, cumulative effects of each increase in the concentration of PM2.5 IQR also showed a unimodal distribution. The largest cumulative effect occurred on the 28th day of lag (RR=1.084457, 95% CI:1.012207,1.161864), and the cumulative RRs were also statistically significant from the 19th day to 30nd days. In the dose-response relationship, as PM2.5 concentrations increased, RR increased. CONCLUSION Year by year, fractures in Shijiazhuang City exhibited an increasing trend. PM2.5 can affect the occurrence of those fractures. The impact on women, adolescents and people of working age is even greater. The supervision of PM2.5 should be strengthened while large-scale emissions should be limited.
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14
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Yoon HE, Lee YH, Lee JE, Lee J, Kim H, Chung BH, Shin SJ. Seasonality in hip fracture among hemodialysis patients and kidney transplant recipients in South Korea. Nephrology (Carlton) 2022; 27:925-933. [PMID: 36136601 DOI: 10.1111/nep.14110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/21/2022] [Accepted: 09/06/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The seasonality of hip fracture in hemodialysis (HD) patients and kidney transplant recipients (KTRs) have not been reported. We assessed seasonal variations in hip fractures among patients with end-stage kidney disease who undergo maintenance HD and KTRs. METHODS Using the Korean National Health Insurance System database from January 2012 to December 2017, monthly counts of hip fracture were calculated among HD patients (n = 77,420) and KTRs (n = 8,921). The 6-year normalized monthly fraction and seasonal fractions of hip fractures were calculated. A cosinor analysis was performed to determine the seasonality of the monthly incidence of hip fractures. RESULTS The 6-year average monthly fraction of hip fractures was lowest in June and highest in October in HD patients, and lowest in February and highest in November in KTRs. The 6-year average seasonal fraction among HD patients was lowest in summer and highest in winter, and lowest in summer and highest in autumn among KTRs, but there was no significant difference. The incidence ratio of hip fractures was lowest in June and highest in January in HD patients, and lowest in August and highest in November in KTRs. On cosinor analysis, HD patients showed significant seasonality in hip fracture incidence, with a trough in summer and a peak in winter (P = 0.031), whereas KTRs did not exhibit a significant trend (P = 0.44). CONCLUSION Hip fractures occurred more frequently in winter and less frequently in summer in patients undergoing HD, whereas KTRs did not show a seasonal trend.
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Affiliation(s)
- Hye Eun Yoon
- Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.,Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeon Hee Lee
- Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.,Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joo Eun Lee
- Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.,Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, Republic of Korea
| | - Hoseob Kim
- Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, Republic of Korea
| | - Byung Ha Chung
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seok Joon Shin
- Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.,Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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15
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Dahl C, Madsen C, Omsland TK, Søgaard AJ, Tunheim K, Stigum H, Holvik K, Meyer HE. The Association of Cold Ambient Temperature With Fracture Risk and Mortality: National Data From Norway-A Norwegian Epidemiologic Osteoporosis Studies (NOREPOS) Study. J Bone Miner Res 2022; 37:1527-1536. [PMID: 35689442 PMCID: PMC9545665 DOI: 10.1002/jbmr.4628] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/12/2022] [Accepted: 06/04/2022] [Indexed: 11/11/2022]
Abstract
Norway is an elongated country with large variations in climate and duration of winter season. It is also a high-risk country for osteoporotic fractures, in particular hip fractures, which cause high mortality. Although most hip fractures occur indoors, there is a higher incidence of both forearm and hip fractures during wintertime, compared with summertime. In a nationwide longitudinal cohort study, we investigated whether cold ambient (outdoor) temperatures could be an underlying cause of this high incidence and mortality. Hospitalized/outpatient forearm fractures (International Classification of Diseases and Related Health Problems, 10th Revision [ICD-10] code S52) and hospitalized hip fractures (ICD-10 codes S72.0-S72.2) from 2008 to 2018 were retrieved from the Norwegian Patient Registry. Average monthly ambient temperatures (degrees Celsius, °C) from the years 2008 to 2018 were provided by the Norwegian Meteorological Institute and linked to the residential area of each inhabitant. Poisson models were fitted to estimate the association (incidence rate ratios [IRRs], 95% confidence intervals [CIs]) between temperature and monthly incidence of total number of forearm and hip fractures. Flexible parametric survival models (hazard ratios [HR], 95% CI) were used to estimate the association between temperature and post-hip fracture mortality, taking the population mortality into account. Monthly temperature ranged from -20.2°C to 22.0°C, with a median of -2.0°C in winter and 14.4°C in summer. At low temperatures (<0°C) compared to ≥0°C, there was a 53% higher risk of forearm fracture (95% CI, 51%-55%) and 21% higher risk of hip fracture (95% CI, 19%-22%), adjusting for age, gender, calendar year, urbanization, residential region, elevation, and coastal proximity. When taking the population mortality into account, the post-hip fracture mortality in both men (HR 1.08; 95% CI, 1.02-1.13) and women (HR 1.09; 95% CI, 1.04-1.14) was still higher at cold temperatures. There was a higher risk of forearm and hip fractures, and an excess post-hip fracture mortality at cold ambient temperatures. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Cecilie Dahl
- University of Oslo, Institute of Health and Society, Department of Community Medicine and Global Health, Oslo, Norway
| | - Christian Madsen
- Norwegian Institute of Public Health, Department of Health and Inequality, Oslo, Norway
| | - Tone Kristin Omsland
- University of Oslo, Institute of Health and Society, Department of Community Medicine and Global Health, Oslo, Norway
| | - Anne-Johanne Søgaard
- Norwegian Institute of Public Health, Department of Physical Health and Ageing, Oslo, Norway
| | | | - Hein Stigum
- University of Oslo, Institute of Health and Society, Department of Community Medicine and Global Health, Oslo, Norway.,Norwegian Institute of Public Health, Department of Physical Health and Ageing, Oslo, Norway
| | - Kristin Holvik
- Norwegian Institute of Public Health, Department of Physical Health and Ageing, Oslo, Norway
| | - Haakon E Meyer
- University of Oslo, Institute of Health and Society, Department of Community Medicine and Global Health, Oslo, Norway.,Norwegian Institute of Public Health, Department of Physical Health and Ageing, Oslo, Norway
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16
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Moral-Cuesta D, Gutiérrez-Misis A, Veloz BAC, Matovelle-Ochoa P, Epelde IM, Alarcón TA, Díez-Sebastián J, Galbete A, Maestre IM, Velilla NM, González-Montalvo JI. Profile and 3-month evolution of geriatric patients after a hip fracture followed-up at a Fracture Liaison Service (FLS). Rev Esp Geriatr Gerontol 2022; 57:205-211. [PMID: 35872030 DOI: 10.1016/j.regg.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 05/29/2022] [Accepted: 06/23/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION There are few studies on Fracture Liaison Service (FLS) that evaluate older patients after a hip fracture (HF) through comprehensive geriatric assessment. We aim to determine these patients' characteristics, outcomes, and prescribed treatments. METHODS A retrospective observational study of a cohort of patients older than 65 years admitted with HFs to an orthogeriatric unit between February 25th (2013) and December 16th (2016). After hospitalization, those patients with a good baseline social, functional, and cognitive situation were referred to the FLS. A comprehensive geriatric assessment and treatment adjustment were conducted. A comparison between FLS patients and HF patients non-referred was made. RESULTS From 1887 patients admitted to the orthogeriatric unit, 469 (23%) were referred to the FLS. Of those, 335 were women (77.2%) and 337 (77.6%) lived in the community. The FLS patients had a better functional status (97.1% of the patients with independent gait versus 79.2%) than non-FLS patients (p<0.001). After 3 months in the FLS, 356 (82%) patients had independent gait and had improved their analytical values. Antiosteoporotic treatment was prescribed to 322 patients (74%), vitamin D supplements to 397 (91.5%), calcium to 321 (74%), and physical exercise to 421 (97%). CONCLUSIONS Patients referred to an FLS were younger, with a better functional and cognitive situation. At hospital discharge, they frequently presented gait impairment and laboratory abnormalities (anemia, hypoproteinemia, vitamin D deficiency) that presented good recovery due to the patient's previous baseline. These patients benefit from comprehensive treatment (pharmacological and non-pharmacological).
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Affiliation(s)
- Debora Moral-Cuesta
- Servicio de Geriatría, Complejo Hospitalario de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (Idisna), Pamplona, Spain.
| | - Alicia Gutiérrez-Misis
- Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Instituto de Investigación Biomédica del Hospital Universitario La Paz (IdiPaz), Madrid, Spain
| | - Bernardo Abel Cedeño Veloz
- Servicio de Geriatría, Complejo Hospitalario de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (Idisna), Pamplona, Spain; Centro de Investigación Biomédica de Navarra (Navarrabiomed), Pamplona, Spain
| | | | - Itxaso Marin Epelde
- Servicio de Geriatría, Complejo Hospitalario de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (Idisna), Pamplona, Spain
| | - Teresa Alarcón Alarcón
- Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Instituto de Investigación Biomédica del Hospital Universitario La Paz (IdiPaz), Madrid, Spain; Servicio de Geriatría, Hospital Universitario La Paz, Madrid, Spain
| | - Jesús Díez-Sebastián
- Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Sección de Epidemiología Clínica del Servicio de Medicina Preventiva, Madrid, Spain
| | - Arkaitz Galbete
- Centro de Investigación Biomédica de Navarra (Navarrabiomed), Pamplona, Spain
| | | | - Nicolás Martínez Velilla
- Servicio de Geriatría, Complejo Hospitalario de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (Idisna), Pamplona, Spain; Centro de Investigación Biomédica de Navarra (Navarrabiomed), Pamplona, Spain
| | - Juan Ignacio González-Montalvo
- Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Instituto de Investigación Biomédica del Hospital Universitario La Paz (IdiPaz), Madrid, Spain; Servicio de Geriatría, Hospital Universitario La Paz, Madrid, Spain
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17
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Surís X, Vela E, Clèries M, Pueyo-Sánchez MJ, Llargués E, Larrosa M. Epidemiology of major osteoporotic fractures: a population-based analysis in Catalonia, Spain. Arch Osteoporos 2022; 17:47. [PMID: 35267128 DOI: 10.1007/s11657-022-01081-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/15/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to estimate the incidence of major osteoporotic fractures in Catalonia, Spain, in 2018 and 2019 and their association with age, sex, income, climate and a set of comorbidities. METHODS Data on age, sex, smoking, alcohol abuse, comorbidities (obesity, Parkinson's disease, arthritis, chronic kidney disease, hepatic cirrhosis, diabetes, chronic obstructive pulmonary disease, dementia, cerebrovascular disease, hyperthyroidism, multiple myeloma and epilepsy) and income levels in people aged ≥ 50 years with a new diagnosis of major osteoporotic fractures in 2018 and 2019 were collected from the Catalan Health Surveillance System (CHSS). Climatological variables were obtained from the Catalan Meteorological Service. Incidence rates were estimated for five major osteoporotic fractures (MOF). Associations between osteoporotic fractures and age, sex, income, comorbidities and climate variables were ascertained through multilevel generalized linear model analysis (Poisson's regression). RESULTS There were 60,671 MOF. The annual incidence rate per 1000 persons/years at risk (PYAR) was 10.6 (3.1 for hip, 2.3 for distal forearm, 2.2 for vertebrae, 1.7 for pelvis and 1.5 for proximal humerus). Female sex, older age, lower income, smoking, alcohol abuse and some common comorbidities were associated with a higher incidence of MOF while obesity was a protective factor. CONCLUSIONS MOF are frequent in the adult Catalan population, especially in older women and people on low incomes. Hip fracture is the most frequent, followed by forearm and vertebral fractures. Smoking, alcohol abuse and some comorbidities were associated with an increased incidence of fracture.
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Affiliation(s)
- Xavier Surís
- Department of Health, Master Plan of Musculoskeletal Diseases, Barcelona, Spain. .,Rheumatology Department, Hospital General de Granollers, C/ Francesc Ribas SN, 08400, Granollers, Barcelona, Spain. .,School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain. .,Catalan Health Service, Catalonia, Spain.
| | - Emili Vela
- Knowledge and Information Unit, Catalan Health Service, Catalonia, Spain.,Digitalization for the Sustainability of the Healthcare System, Catalonia, Spain
| | - Montserrat Clèries
- Knowledge and Information Unit, Catalan Health Service, Catalonia, Spain.,Digitalization for the Sustainability of the Healthcare System, Catalonia, Spain
| | - Maria-Jesús Pueyo-Sánchez
- Department of Health, Master Plan of Musculoskeletal Diseases, Barcelona, Spain.,Catalan Health Service, Catalonia, Spain
| | - Esteve Llargués
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.,Internal Medicine Department, Hospital General de Granollers, Granollers, Spain
| | - Marta Larrosa
- Department of Health, Master Plan of Musculoskeletal Diseases, Barcelona, Spain
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Nishimura H, Nawa N, Ogawa T, Fushimi K, Fujiwara T. Association of ambient temperature and sun exposure with hip fractures in Japan: A time-series analysis using nationwide inpatient database. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:150774. [PMID: 34619189 DOI: 10.1016/j.scitotenv.2021.150774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence on whether meteorological conditions affect hip fractures (HFs) is limited. This study aimed to clarify the associations between ambient temperature and sun exposure and HFs in Japan. METHODS Record of daily hospital admissions for HFs between 2015 and 2018 were extracted from a Japanese nationwide inpatient database. We conducted a time-series quasi-Poisson regression analysis using a distributed lag non-linear model with lag 0-39 days to estimate prefecture-specific relative risks (RRs) of HFs. We also estimated pooled RRs using random-effects meta-analysis. RESULTS We identified 355,563 HFs. For mean temperature, immediate RRs (lag 0-2 days) were 1.349 (95% confidence interval (CI): 1.305, 1.395) and 0.754 (95% CI: 0.727, 0.782) for low (mean of the 2.5th percentile) and high (mean of the 97.5th percentile) mean temperature, respectively, relative to the reference (mean of medians). For sunshine duration, immediate RRs were 0.929 (95% CI: 0.913, 0.946) and 1.056 (95% CI: 1.029, 1.085) for short (mean of the 2.5th percentile) and long (mean of the 97.5th percentile) sunshine duration, respectively, and delayed RRs (lag 3-39 days) was 0.770 (95% CI: 0.696, 0.851) for long sunshine duration relative to the reference (mean of medians). Immediate RRs were larger for both exposures in patients admitted from home than in those from care facilities. CONCLUSIONS Lower mean temperature and longer sunshine duration were associated with immediate higher HF risks. Higher mean temperature and shorter sunshine duration were associated with immediate lower HF risks. These associations were modified by admission routes. Longer sunshine duration was also associated with delayed lower HF risks.
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Affiliation(s)
- Hisaaki Nishimura
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobutoshi Nawa
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahisa Ogawa
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan; Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
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Ormeño Illanes JCR, Quevedo Langenegger I. Higher latitude and lower solar radiation influence on hip fracture admissions in Chilean older population. Osteoporos Int 2021; 32:2033-2041. [PMID: 33818634 DOI: 10.1007/s00198-021-05910-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/03/2021] [Indexed: 12/25/2022]
Abstract
UNLABELLED Data linking solar radiation with fractures are lacking. We found that lower solar radiation was associated with higher hip fracture admission rates in men from Chile. This supports the idea that solar radiation, a surrogate of vitamin D, may be involved in the development of fractures in older population. INTRODUCTION : To explore the associations between solar radiation and latitude with hip fracture admission rates in people aged 65 years or older in Chile, the country with the greatest variation in solar radiation in the world. METHODS In this ecological study, we investigated the associations between regional solar radiation and latitude with hospitalizations due to hip fracture in population aged 65 years or older, by reviewing national records between 2013 and 2018. We also evaluated the role of sociodemographic factors such as poverty, education, indigenous ethnicity, and rurality rates. RESULTS Between 2013 and 2018, there were 44,328 admissions due to hip fracture in people aged 65 years or older; 77.5% were women and 65.1% were aged 80 years or older. The national admission rate was 389.3 per 100,000 inhabitants (95% CI: 382.4-396.2). The highest admission rate was registered in the Region IX (445.3 per 100,000, 95% CI: 398.3-492.4), which has the highest poverty rates, indigenous ethnicity rates, and rurality rates. We found a north-south increasing gradient of admission rates in men (β=1.5 [95% CI: 0 to 3], p=0.044) and a significant association between solar radiation and admission rates in men (β=-4.4 [95% CI: -8 to 0.8], p=0.02). Admission rates in men were also associated with sociodemographic variables such as poverty (β=2.4 [95% CI: 0 to 4.8], p=0.048) and rurality rates (β=1.2 [95% CI: 0.1 to 2.4], p=0.039). CONCLUSION Regional solar radiation and latitude were associated with hip fracture admission rates in men aged 65 years or older in Chile, with highest admission rates at higher latitudes and lower solar radiation.
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Affiliation(s)
| | - I Quevedo Langenegger
- Endocrinology Section, Department of Internal Medicine, School of Medicine, University of Concepción, Concepción, Chile
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Dahl C, Madsen C, Omsland TK, Søgaard AJ, Tell GS, Holvik K, Meyer HE. Contribution of elevation and residential proximity to the coast in explaining geographic variations in hip fracture incidence. A Norwegian Epidemiologic Osteoporosis Studies (NOREPOS) study. Osteoporos Int 2021; 32:1001-1006. [PMID: 33247392 DOI: 10.1007/s00198-020-05736-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/08/2020] [Indexed: 12/21/2022]
Abstract
UNLABELLED A higher risk of hip fracture was found in areas of Norway at higher elevation and farther from the coast. However, the previously seen county variations could not be explained by these geographical factors. INTRODUCTION Norway is an elongated country extending north of the Arctic Circle with substantial coast-inland variation in topography and climate. Differences in hip fracture incidence between counties and a distinct seasonal variation have previously been shown. The aim of the current study was to explore these variations further by considering associations of height above sea level (elevation) and distance to the coast with hip fracture incidence. METHODS All patients with hip fractures admitted to Norwegian hospitals in the period 2009-2018 were included. Individual residential elevation and distance to the coast was calculated in Geographic Information Systems and combined with individual-level population data on all Norwegians 50 years of age or older during the observation period, including hospital information on fractures. Age-standardized incidences rate and incidence rate ratios with 95% confidence intervals (IRR, 95% CI) according to elevation and coastal proximity were estimated. The associations were tested using Poisson models adjusting for sex, urban/rural location of residency, country of birth, and season of hip fracture occurrence. RESULTS From 2009 to 2018, there were 85,776 first hip fractures. There was an increasing risk with higher residential elevation (above versus below mean) for women: IRR = 1.04, 95% CI: 1.02, 1.05), but not for men (IRR = 1.00, 95% CI: 0.97, 1.02). Incidence of hip fracture increased with distance from the coast. Women residing the farthest away from the coast (above versus below mean distance) had a higher age-adjusted incidence of hip fracture compared to those living closer to the coast (IRR = 1.04 (95% CI: 1.02, 1.06), whereas no association was found in men (IRR = 1.00 (95% CI: 1.00, 1.01). Combining elevation and distance to coast showed a higher incidence in women living at high elevation far from the coast compared with women living at low elevation near the coast (IRR = 1.07, 95% CI: 1.04, 1.10). A similar result was found in men but only for hip fractures occurring during March-May (IRR = 1.07, 95% CI: 1.00, 1.15). The previously shown patterns of county differences and seasonal variations were unchanged when considering geography. CONCLUSION We found a somewhat higher incidence of hip fracture in inland residents living in areas of high elevation, as compared to those living in more coastal proximity; however, the geographic variation did not explain county and seasonal differences in fracture incidence in Norway. More in-depth analyses on temperature and climate factors may give further clues.
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Affiliation(s)
- C Dahl
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Box 1130, Blindern, 0318, Oslo, Norway.
| | - C Madsen
- Department of Health and Inequality, Norwegian Institute of Public Health, Oslo, Norway
| | - T K Omsland
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Box 1130, Blindern, 0318, Oslo, Norway
| | - A-J Søgaard
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - G S Tell
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - K Holvik
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - H E Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Box 1130, Blindern, 0318, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
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Zhong H, Poeran J, Liu J, Wilson LA, Memtsoudis SG. Hip fracture characteristics and outcomes during COVID-19: a large retrospective national database review. Br J Anaesth 2021; 127:15-22. [PMID: 33965205 PMCID: PMC8049451 DOI: 10.1016/j.bja.2021.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/23/2021] [Accepted: 04/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background The COVID-19 pandemic has impacted healthcare in various vulnerable patient subpopulations. However, data are lacking on the impact of COVID-19 on hip fractures, seen mainly in older patients. Using national claims data, we aimed to describe the epidemiology during the first COVID-19 wave in the USA. Methods We compared patients admitted for hip fractures during March and April of 2020 with those admitted in 2019 in terms of patient and healthcare characteristics, COVID-19 diagnosis, and outcomes. An additional comparison was made between COVID-19-positive and -negative patients. Outcomes included length of hospital stay (LOS), admission to an ICU, ICU LOS, use of mechanical ventilation, 30-day readmission, discharge disposition, and a composite variable of postoperative complications. Results Overall, 16 068 hip fractures were observed in 2019 compared with 7498 in 2020. Patients with hip fractures in 2020 (compared with 2019) experienced earlier hospital discharge and were less likely to be admitted to ICU, but more likely to be admitted to home. Amongst 83 patients with hip fractures with concomitant COVID-19 diagnosis, we specifically observed more non-surgical treatments, almost doubled LOS, a more than 10-fold increased mortality rate, and higher complication rates compared with COVID-19-negative patients. Conclusions The COVID-19 pandemic significantly impacted not only volume of hip fractures, but also patterns in care and outcomes. These results may inform policymakers in future outbreaks and how this may affect vulnerable patient populations, such as those experiencing a hip fracture.
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Affiliation(s)
- Haoyan Zhong
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
| | - Jashvant Poeran
- Institute for Healthcare Delivery Science, Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jiabin Liu
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Lauren A Wilson
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
| | - Stavros G Memtsoudis
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA; Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria; Department of Health Policy and Research, Weill Cornell Medical College, New York, NY, USA.
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22
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Nazemi AK, Al-Humadi SM, Tantone R, Hays TR, Bowen SN, Komatsu DE, Divaris N. Hip Fractures Before and During the COVID-19 Pandemic: Comparative Demographics and Outcomes. Geriatr Orthop Surg Rehabil 2021; 12:21514593211003077. [PMID: 33796344 PMCID: PMC7983432 DOI: 10.1177/21514593211003077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction During the height of the COVID-19 pandemic in New York, hip fractures requiring operative management continued to present to Stony Brook University Hospital. Given the novelty of SARS-CoV-2, there is recent interest in the pandemic and its relationship to orthopedic operative outcomes. This retrospective cohort study compared outcomes for operative hip fractures in patients prior to and during the COVID-19 pandemic at a level 1 academic center. Materials and Methods: Data was collected on patients age 18 years or older who underwent operative management for hip fractures performed from January 21, 2019 to July 1, 2019 (pre-pandemic) or from January 21, 2020 to July 1, 2020 (pandemic). COVID-19 status, demographics and outcomes were analyzed. Results Overall, 159 patients with hip fractures were included in this study, 103 in the 2019 group and 56 in the 2020 group. Within the 2019 group, there was a significantly greater proportion of female patients compared to 2020 (p = 0.0128). The length of hospital stay was shorter for the 2020 group by 1.84 days (p = 0.0138). COVID-19 testing was positive in 4 (7.1%) patients in the 2020 group, negative for 22 patients (39.3%), and the remaining 30 patients in the 2020 group (53.7%) were not tested during their admission. There were no other significant differences in demographics or outcomes between the 2019 and 2020 groups. Discussion The COVID-19 pandemic did not significantly alter most aspects of care for hip fracture patients at our institution. Interestingly, postoperative pulmonary outcomes were not affected by the pandemic. Conclusions In this study, a significantly higher proportion of males presented with hip fractures in the pandemic group. In addition, the average length of hospital stay was shorter during the COVID-19 pandemic. Further research is needed to understand the nuances that may lead to improved care for patients with hip fractures during a pandemic.
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Affiliation(s)
- Alireza K Nazemi
- Department of Orthopaedic Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Samer M Al-Humadi
- Department of Orthopaedic Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Ryan Tantone
- Department of Orthopaedic Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Thomas R Hays
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Stephen N Bowen
- Department of Orthopaedic Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - David E Komatsu
- Department of Orthopaedic Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Nicholas Divaris
- Department of Orthopaedic Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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Seo HS, Hong J, Jung J. Relationship of meteorological factors and air pollutants with medical care utilization for gastroesophageal reflux disease in urban area. World J Gastroenterol 2020; 26:6074-6086. [PMID: 33132656 PMCID: PMC7584054 DOI: 10.3748/wjg.v26.i39.6074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/19/2020] [Accepted: 09/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is a highly prevalent disease of the upper gastrointestinal tract, and it is associated with environmental and lifestyle habits. Due to an increasing interest in the environment, several groups are studying the effects of meteorological factors and air pollutants (MFAPs) on disease development.
AIM To identify MFAPs effect on GERD-related medical utilization.
METHODS Data on GERD-related medical utilization from 2002 to 2017 were obtained from the National Health Insurance Service of Korea, while those on MFAPs were obtained from eight metropolitan areas and merged. In total, 20071900 instances of GERD-related medical utilizations were identified, and 200000 MFAPs were randomly selected from the eight metropolitan areas. Data were analyzed using a multivariable generalized additive Poisson regression model to control for time trends, seasonality, and day of the week.
RESULTS Five MFAPs were selected for the prediction model. GERD-related medical utilization increased with the levels of particulate matter with a diameter ≤ 2.5 μm (PM2.5) and carbon monoxide (CO). S-shaped and inverted U-shaped changes were observed in average temperature and air pollutants, respectively. The time lag of each variable was significant around nine days after exposure.
CONCLUSION Using five MFAPs, the final model significantly predicted GERD-related medical utilization. In particular, PM2.5 and CO were identified as risk or aggravating factors for GERD.
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Affiliation(s)
- Ho Seok Seo
- Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
| | - Jinwook Hong
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine and Science, Incheon 21565, South Korea
| | - Jaehun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine and Science, Incheon 21565, South Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon 21565, South Korea
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Lubbe RJ, Miller J, Roehr CA, Allenback G, Nelson KE, Bear J, Kubiak EN. Effect of Statewide Social Distancing and Stay-At-Home Directives on Orthopaedic Trauma at a Southwestern Level 1 Trauma Center During the COVID-19 Pandemic. J Orthop Trauma 2020; 34:e343-e348. [PMID: 32815849 PMCID: PMC7446999 DOI: 10.1097/bot.0000000000001890] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To compare orthopaedic trauma volume and mechanism of injury before and during statewide social distancing and stay-at-home directives. DESIGN Retrospective. SETTING Level 1 trauma center. PATIENTS/PARTICIPANTS One thousand one hundred thirteen patients sustaining orthopaedic trauma injuries between March 17 and April 30 of years 2018, 2019, and 2020. INTERVENTION Statewide social distancing and stay-at-home directives. MAIN OUTCOME MEASUREMENTS Number of consults, mechanism of injury frequency, and type of injury frequency. RESULTS During the COVID-19 pandemic, orthopaedic trauma consult number decreased. Injuries due to gunshot wounds increased and those due to automobile versus pedestrian accidents decreased. Time-to-presentation increased and length of stay decreased. Operative consults remained unchanged. CONCLUSIONS Orthopaedic trauma injuries continued to occur during the COVID-19 pandemic at an overall decreased rate, however, with a different distribution in mechanism and type of injury. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Ryan J. Lubbe
- Department of Orthopaedic Surgery, University of Nevada Las Vegas School of Medicine, Las Vegas, NV; and
| | - Jordan Miller
- Department of Orthopaedic Surgery, University of Nevada Las Vegas School of Medicine, Las Vegas, NV; and
| | - Casey A. Roehr
- Department of Orthopaedic Surgery, University of Nevada Las Vegas School of Medicine, Las Vegas, NV; and
| | - Gayle Allenback
- Department of Orthopaedic Surgery, University of Nevada Las Vegas School of Medicine, Las Vegas, NV; and
- OptumCare Orthopaedics and Spine, OptumCare, Las Vegas, NV
| | - Karen E. Nelson
- Department of Orthopaedic Surgery, University of Nevada Las Vegas School of Medicine, Las Vegas, NV; and
- OptumCare Orthopaedics and Spine, OptumCare, Las Vegas, NV
| | - Jessica Bear
- Department of Orthopaedic Surgery, University of Nevada Las Vegas School of Medicine, Las Vegas, NV; and
- OptumCare Orthopaedics and Spine, OptumCare, Las Vegas, NV
| | - Erik N. Kubiak
- Department of Orthopaedic Surgery, University of Nevada Las Vegas School of Medicine, Las Vegas, NV; and
- OptumCare Orthopaedics and Spine, OptumCare, Las Vegas, NV
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Weather Conditions and Outdoor Fall Injuries in Northwestern Russia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176096. [PMID: 32825697 PMCID: PMC7504524 DOI: 10.3390/ijerph17176096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/02/2022]
Abstract
This study aimed to investigate associations between the weather conditions and the frequency of medically-treated, non-fatal accidental outdoor fall injuries (AOFIs) in a provincial region of Northwestern Russia. Data on all non-fatal AOFIs that occurred from January 2015 through June 2018 (N = 1125) were extracted from the population-based Shenkursk Injury Registry (SHIR). Associations between the weather conditions and AOFIs were investigated separately for the cold (15 October–14 April) and the warm (15 April–14 October) seasons. Negative binomial regression was used to investigate daily numbers of AOFIs in the cold season, while zero-inflated Poisson regression was used for the warm season. The mean daily number of AOFIs was 1.7 times higher in the cold season compared to the warm season (1.10 vs. 0.65, respectively). The most typical accident mechanism in the cold season was slipping (83%), whereas stepping wrong or stumbling over something was most common (49%) in the warm season. The highest mean daily incidence of AOFIs in the cold season (20.2 per 100,000 population) was observed on days when the ground surface was covered by compact or wet snow, air temperature ranged from −7.0 °C to −0.7 °C, and the amount of precipitation was above 0.4 mm. In the warm season, the highest mean daily incidence (7.0 per 100,000 population) was observed when the air temperature and atmospheric pressure were between 9.0 °C and 15.1 °C and 1003.6 to 1010.9 hPa, respectively. Along with local weather forecasts, broadcasting warnings about the increased risks of outdoor falls may serve as an effective AOFI prevention tool.
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Gomez-Vaquero C, Valencia L, Nolla JM, Boquet D, Martínez Pardo S, Mihaylov Grigorov M, Lafont A, Segalés N, Roig Vilaseca D, Cerdà D, Casado E, Oncins X, Sallés M, Mínguez S, García Mira Y, Holgado S, López Louzao A, Pitarch C, Castellanos Moreira R, Florez H, Tebé C. The incidence of clinical fractures in adults aged 50 years and older in Spain. Rheumatol Adv Pract 2020. [DOI: 10.1093/rap/rkaa050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
The aim of this study was to quantify the incidence of all clinical fractures, including traumatic and fragility fractures, in patients aged 50 years and older, and to describe their distribution by fracture location, sex and age.
Methods
The incidence of clinical fractures at 10 hospitals in Catalonia, with a reference population of 3 155 000 inhabitants, was studied. For 1 week, from 30 May to 5 June 2016, we reviewed the discharge reports of the Traumatology section of the Emergency Department to identify all fractures diagnosed in patients ≥50 years of age. As a validation technique, data collection was carried out for 1 year at one of the centres, from 1 December 2015 to 30 November 2016. The fracture incidence, including the 95% CI, was estimated for the entire sample and grouped by fracture type, location, sex and age.
Results
A total of 283 fractures were identified. Seventy per cent were in women, with a mean age of 72 years. The overall fracture incidence was 11.28 per 1000 person-years (95% CI: 11.10, 11.46), with an incidence of traumatic and fragility fractures of 4.15 (95% CI: 4.04, 4.26) and 7.13 per 1000 person-years (95% CI: 6.99, 7.28), respectively. The incidence of fractures observed in the validation sample coincided with that estimated for the whole of Catalonia. The most common fragility fractures were of the hip, forearm, humerus and vertebrae.
Conclusion
The results of this study are the first to estimate the incidence of clinical fragility fractures in Spain, grouped by location, age and sex.
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Affiliation(s)
- Carmen Gomez-Vaquero
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Universitari de Bellvitge, L’Hospitalet
| | - Lidia Valencia
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Universitari de Bellvitge, L’Hospitalet
| | - Joan M Nolla
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Universitari de Bellvitge, L’Hospitalet
| | - Dolors Boquet
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Universitari Arnau de Vilanova, Lleida
| | - Silvia Martínez Pardo
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Universitari Mútua Terrassa, Terrassa
| | - Mihail Mihaylov Grigorov
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Universitari Mútua Terrassa, Terrassa
| | - Anna Lafont
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital de Mataró, Mataró
| | - Nuria Segalés
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital de Mataró, Mataró
| | - Daniel Roig Vilaseca
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí
| | - Dacia Cerdà
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí
| | - Enrique Casado
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology and Orthopedics Departments, Parc Taulí Hospital Universitari, Sabadell
| | - Xavier Oncins
- Rheumatology and Orthopedics Departments, Parc Taulí Hospital Universitari, Sabadell
| | - Meritxell Sallés
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Sant Joan de Déu de Manresa, Manresa
| | - Sonia Mínguez
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Sant Joan de Déu de Manresa, Manresa
| | - Yaiza García Mira
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Susana Holgado
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Ana López Louzao
- Rheumatology and Orthopedics Departments, Hospital de l’Esperit Sant, Santa Coloma de Gramenet
| | - Conxita Pitarch
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology and Orthopedics Departments, Hospital de l’Esperit Sant, Santa Coloma de Gramenet
| | - Raúl Castellanos Moreira
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Clínic de Barcelona, Barcelona
| | - Helena Florez
- Osteoporosis Working Group of the Catalonian Society for Rheumatology (OsCat)
- Rheumatology Department, Hospital Clínic de Barcelona, Barcelona
| | - Cristian Tebé
- Statistical Advisory Service, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet, Spain
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Forsén L, Søgaard AJ, Holvik K, Meyer HE, Omsland TK, Stigum H, Dahl C. Geographic variations in hip fracture incidence in a high-risk country stretching into the Arctic: a NOREPOS study. Osteoporos Int 2020; 31:1323-1331. [PMID: 32095840 PMCID: PMC7280325 DOI: 10.1007/s00198-020-05346-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 02/12/2020] [Indexed: 12/21/2022]
Abstract
UNLABELLED There are geographic variations in hip fracture incidence rates across Norway, with a lower incidence in the coastal areas of the southwest and in the Arctic north, contrary to what may be expected with regard to vitamin D exposure from sunlight. The regional differences have become smaller in recent years. INTRODUCTION To investigate geographic variation in hip fracture incidence within Norway and regional differences in time trends. METHODS All hip fractures treated in Norwegian hospitals 2002-2013 were included, and demographic information was obtained from Statistics Norway. Age-standardized incidence rates were calculated separately for 19 counties. Incidence rate ratios with 95% confidence intervals for county differences and time trends were estimated using Poisson regression. RESULTS Age-standardized number of hip fractures per 10,000 person-years varied between counties from 69 to 84 in women and from 34 to 41 in men. The highest rates were observed in the southeastern capital city of Oslo, while rates were low in the four northernmost counties. There was an east-west gradient, with lower incidence in the coastal southwest compared with the southeast. Women showed a statistically significant decline during 2002-2013 in almost all counties (up to 31%). In men, only a few counties showed a decline. In both genders, hip fracture rates at age 80 in the combined five counties with the highest rates were significantly higher than in the combined five counties with the lowest rates across the period, although the trends converged over time. CONCLUSIONS In Norway, the hip fracture incidence was lower in the north compared with the south. In addition, we observed an east-west gradient with the highest incidence in the southeast and lower incidence in the coastal southwest. While there has been an overall declining trend in hip fracture incidence over time, regional differences are still apparent.
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Affiliation(s)
- L Forsén
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - A J Søgaard
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - K Holvik
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - H E Meyer
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - T K Omsland
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - H Stigum
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - C Dahl
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, N-0318, Oslo, Norway.
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Juan A, Frontera G, Cacheda AP, Ros I, Narváez J, Marí B, Nolla JM. Epidemiology of osteoporosis and its determinants in physically active Majorcan elderly. Mediterr J Rheumatol 2020; 31:42-49. [PMID: 32411932 PMCID: PMC7219640 DOI: 10.31138/mjr.31.1.42] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objective: To estimate the prevalence and distribution of determinants of osteoporosis (OP) in a population of physically active Majorcans over 60. Methods: Health survey in which consecutive women and men above 60 years old visiting sports facilities during a two-month period were recruited. All underwent a densitometry of the lumbar spine (LS) and femoral neck (FN). Osteoporosis was defined according to the World Health Organization densitometric criteria (T-score <2.5 SD in the LS or FN, and osteopenia if the result was between −2.5 and −1 SD). As osteoporosis shows substantial differences between genders, the study of its determinants was conducted independently for men and women. Results: The sample included 731 subjects (86% female), with an average age of 70 (SD 5) among men and 65 (8) among women. The overall prevalence of osteoporosis was 35.7% in the LS, 8.9% in the FN and 39.4% in the LS and/or FN. The analysis by gender showed a higher prevalence of osteoporosis in women than in men (43.8 % vs. 11.1%). The presence of osteoporosis increased with age in men and women (7.8% for 61–75 years old vs 22.7% > 75 years old for men and 48.5% for 61–75 years old vs 62.7% > 75 for women). Conclusions: Densitometric osteoporosis is frequent among physically active elderly population, and higher than expected in a largely sunlight-exposed area.
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Affiliation(s)
- Antonio Juan
- Servicio de Reumatología, Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain
| | - Guillem Frontera
- Unidad de Investigación, Hospital Universitari de Son Espases, Palma de Mallorca, Spain
| | - Ana Paula Cacheda
- Servicio de Reumatología, Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain
| | - Inmaculada Ros
- Servicio de Reumatología, Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain
| | - Javier Narváez
- Servicio de Reumatología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.,IDIBELL, L'Hospitalet de Llobregat, Spain
| | | | - Joan Miquel Nolla
- Servicio de Reumatología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.,IDIBELL, L'Hospitalet de Llobregat, Spain
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Shi T, Min M, Ye P, Wang Y, Qu G, Zhang Y, Liang M, Sun Y, Duan L, Bi P. Meteorological variables and the risk of fractures: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 685:1030-1041. [PMID: 31390694 DOI: 10.1016/j.scitotenv.2019.06.281] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/30/2019] [Accepted: 06/18/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE The association between meteorological variables and risk of fractures has attracted increasing attentions but remain controversial. Therefore, our main aim is to clarify the association, and also to identify possible susceptible groups. METHODS Relevant literature was obtained through standard MeSH literature searching seven electronic databases. Because some studies expressed the association as the rate of incidence (IRR) of fractures associated with each 1 °C rise in temperature and 1% increase in relative humidity (RH), some expressed as IRR of fractures for the day with specific climatic variable versus control days, and also the association was expressed as correlations coefficients (COR) in some studies, separated meta-analyses were undertaken, with one based on IRR and another based on COR. RESULTS A total of 24 studies were included. Results showed that each 1 °C increase was significantly associated with a 3.0% decrease in fracture risk (IRR = 0.970, 95%CI: 0.952-0.988). The day with freezing rain and snow were associated with increased risk for both the lower extremity fracture (freezing rain: IRR = 1.174, 95%CI: 1.022-1.348; snow: IRR = 1.245, 95%CI: 1.050-1.477) and the upper extremity fracture (freezing rain: IRR = 1.376, 95%CI: 1.192-1.588; snow: IRR = 1.548, 95%CI: 1.361-1.761). No significant association was detected between RH, dew, frost, fog, storm and high wind, and fracture. The COR meta-analysis showed that mean temperature (moderately), maximum temperature (moderately), rainfall (weakly) and sunlight duration (weakly) were correlated with fracture occurrence. CONCLUSION The incidence of fractures was increased in lower temperature, the day with freezing rain, and snow. Other meteorological factors may have some effects on the incidence of fracture. The association maybe stronger for males, lower extremity fracture, and people living in Asia, subtropical zone, low-latitude, and northern hemisphere. Further studies are needed.
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Affiliation(s)
- Tingting Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Min Min
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Room 916, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Yuan Wang
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Room 916, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Yun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Leilei Duan
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Room 916, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Peng Bi
- School of Public Health, the University of Adelaide, Adelaide, SA 5005, Australia.
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Souza MMD, Souza EMD, Nunes AA, Martinez EZ. Seasonal variation of femoral fractures in the state of São Paulo, Southeast Brazil. Rev Saude Publica 2019; 53:55. [PMID: 31432912 PMCID: PMC6703896 DOI: 10.11606/s1518-8787.2019053001051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/22/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine the effect of seasonality on femoral fracture incidence among people residing in the state of São Paulo, Brazil. METHODS Ecological study based on a consecutive series of 216,348 reports of hospital admissions caused by femoral fractures. A Bayesian statistical model was used for time series analysis, considering the monthly average number of events of femoral fractures per day as a dependent variable. RESULTS Among the female population, significant seasonal effects were observed only for older women, aged 60 years or more. Among younger men (aged less than 20 years) there is not a clear seasonal effect, but among the other age groups there seems to exist a higher number of cases of femoral fractures during the coldest months of the year. CONCLUSIONS In general, more cases of fractures occur during the coldest months of the year; however, men and women have different patterns of incidence according to each age group.
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