Systematic review of the association between climate and hip fractures

Abstract

This study aims to systematically review epidemiological studies that evaluate the relationship between meteorology and the incidence of hip fracture (HF). After a search in Scopus, PubMed, and Embase, two independent authors assessed the relevance of studies and extracted data for description. From each study, we extracted the geographic and temporal scope, design, study variables (meteorological and related to HF), statistical analysis, and estimated associations. Of a total of 134 works, 20 studies were selected. All use an ecological design but one case-crossover. Most studies have been conducted in northern latitudes. The analysis methodology did not take into account the temporal structure of the data in 10 studies (regression and linear correlations); the rest used Poisson regression (7) and ARIMA model (3). Most studies showed significant positive associations with rainfall, especially in the form of snow: HF relative risk (RR) on days with precipitation vs. days without precipitation that ranged from 1.14 (95 % confidence interval (CI)1.04 to 1.24) to 1.60 (95 % CI 1.06 to 2.41), the temperature, with RR by one degree Celsius decline from 1.012 (95 % CI 1.004 to 1.020) to 1.030 (95 % CI 1.023 to 1.037), and wind (3) RR FC windiest days vs. calm days: 1.32 (95 % CI 1.10 to 1.58) to 1.35 (95 % CI 0.88 to 2.08). This review shows that analytic methods are very heterogeneous and poorly adapted to the temporary nature of the data. Studies confirm a certain seasonality, with more fractures in winter and meaningful relationships with meteorological conditions typical of this season.

Keywords: Climate; Epidemiology; Hip fracture; Systematic review.