Abstract
ABSTRACTOBJECTIVE 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.
Highlights
Femoral fractures are a common cause of mortality and functional loss, mainly among older people[1,2]
In general, more cases of fractures occur during the coldest months of the year; men and women have different patterns of incidence according to each age group
The incidence of femoral fractures according to age groups and sex are shown in Table 1, considering the years of 2008, 2011, 2014, and 2017, with the rates per 100,000 population
Summary
Femoral fractures are a common cause of mortality and functional loss, mainly among older people[1,2]. Osteoporosis is one of the main risk factors for these fractures[3], and other known risk factors are falls, early menopause, and sedentary lifestyle[1,2,3,4]. It is estimated that the life expectancy of patients suffering from femoral fracture is reduced from 15% to 20%4. A review study showed that, in Brazil, 5.5% of patients with fracture in the proximal third of the femur die during hospitalization and 4.7% die at the end of one month of follow-up[5]. The cost per femoral fracture surgery is significant to the Brazilian health system, as the direct cost of hospitalization is estimated between 4,100 and 70,000 dollars. The hospital medical resources used in the postoperative period accounted for 5.7% of the direct cost of hospitalization[6]
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