A Higher Charlson Comorbidity Index Is a Risk Factor for Hip Fracture in Older Adults During Low-Temperature Periods: A Cross-Sectional Study

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.

Keywords: Charlson Comorbidity Index; aged; hip fracture; older adults; temperature.

Figure 1

The distribution of hip fracture patients (depicted in blue) and the number of daily average temperatures (depicted in black) are shown in five different temperature intervals during the study period.