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.

中文翻译：

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西班牙加泰罗尼亚髋部骨折的趋势和季节性：探索气候的影响

摘要

描述 2010-2019 年加泰罗尼亚 65 岁以上人群髋部骨折 (HF) 发病率的长期趋势和季节性及其与气候变量的关系。按性别、年龄组（65-74、75-84 和 ≥ 85）以及骨折类型（囊外和囊内）对结果进行分析。收集2010年1月1日至2019年12月31日期间诊断为心力衰竭的患者的性别、年龄、骨折类型、住院年份和月份的数据。获得了粗略和标准化的心力衰竭发生率 (HFi)。气候变量（温度、日照、结冰天数、降雨、相对湿度、气压和风力）的月平均值数据是从加泰罗尼亚气象站网络获得的。时间序列分析统计用于识别趋势和季节性。使用线性回归和季节性自回归积分移动平均值（ARIMA）来分析每个气候参数与骨折率的关系。此外，广义相加模型用于确定最佳预测模型。心力衰竭发作总数为 90,149 例（女性 74.1%，男性 25.9%）。 2010 年至 2019 年间，心衰总数增加了 6.4%。中位年龄 (SD) 为 84.5 岁 (7.14)，54% 的患者年龄≥ 85 岁。囊外骨折是最常见的（55%）。标准化发病率从 728.1/100,000 (95% CI 738.6–769.3) 下降至 624.5/100,000 (95% CI 648.7–677.0)，下降了 14.2% ( p  < 0.05)。年龄较大时下降幅度更大。存在季节性差异，秋季（27.2%）和冬季（25.7%）发病率较高，夏季（23.5%）和春季（23.6%）发病率较低。季节性在老年人和男性中更为明显。在双变量回归分析中，高温和较大的日照与心力衰竭发生率呈负相关，而结冰天数、阴雨天数和高相对湿度与所有年龄组和性别的骨折发生率较高相关。在使用季节性 ARIMA 模型的回归分析中，在按趋势和其他气候参数进行调整后，只有日照与整体 HFi 具有一致的显着关联。尽管由于老年人口的增加，加泰罗尼亚的全球心力衰竭数量有所增加，但 2010 年至 2019 年期间，标准化心力衰竭发生率有所下降。存在季节性趋势，以寒冷月份为主，并且与气候参数尤其是日照相关。