Is Cold Apparent Temperature Associated With the Hospitalizations for Osteoporotic Fractures in the Central Areas of Wuhan? A Time-Series Study

The impact of apparent temperature on the emergency visits for traumatic fractures in Hangzhou, China

BACKGROUND

Traumatic fractures occur frequently worldwide. However, research remains limited on the association between short-term exposure to temperature and traumatic fractures. This study aims to explore the impact of apparent temperature (AT) on emergency visits (EVs) due to traumatic fractures.

METHODS

Based on EVs data for traumatic fractures and the contemporary meteorological data, a generalized Poisson regression model along with a distributed lag nonlinear model (DLNM) were undertaken to determine the impact of AT on traumatic fracture EVs. Subgroup analysis by gender and age and sensitivity analysis were also performed.

RESULTS

A total of 25,094 EVs for traumatic fractures were included in the study. We observed a wide "J"-shaped relationship between AT and risk of traumatic fractures, with AT above 9.5 °C positively associated with EVs due to traumatic fractures. The heat effects became significant at cumulative lag 0-11 days, and the relative risk (RR) for moderate heat (95th percentile, 35.7 °C) and extreme heat (99.5th percentile, 38.8 °C) effect was 1.311 (95% CI: 1.132-1.518) and 1.418 (95% CI: 1.191-1.688) at cumulative lag 0-14 days, respectively. The cold effects were consistently non-significant on single or cumulative lag days across 0-14 days. The heat effects were higher among male and those aged 18-65 years old. The sensitivity analysis results remained robust.

CONCLUSION

Higher AT is associated with cumulative and delayed higher traumatic fracture EVs. The male and those aged 18-65 years are more susceptible to higher AT.

Effects of rehabilitation therapy based on exercise prescription on motor function and complications after hip fracture surgery in elderly patients

BACKGROUND

Exercise rehabilitation training is an important measure for improving the prognosis of patients with hip fractures. However, the particular program that works effectively and the efficiency of exercise therapy are still controversial.

OBJECTIVE

To compare the effects of usual postoperative care combined with rehabilitation based on exercise prescription on motor function and complications in elderly patients who underwent surgery for hip fracture.

METHODS

This was an observational study. A total of 71 elderly patients with hip fractures who were treated with hip arthroplasty and internal fixation of the proximal femur with an intramedullary nail at Suzhou Municipal Hospital from October 2020 to December 2021 were included; 11 cases were excluded (eight cases were excluded due to loss of follow-up, two due to deaths from other causes, and one due to other reasons). Finally, 60 patients (18 males and 42 females) were included. Patients were randomly assigned to the control (n = 30) and experimental (n = 30) groups using a random number generator. Patients in the control group received usual postoperative care, whereas those in the experimental group received usual postoperative care combined with rehabilitation training based on the principles of exercise prescription. We recorded the motor function (Harris hip score), daily living ability (Barthel Index), and complications at discharge and 1, 3, and 6 months postoperatively for statistical analysis.

RESULTS

The Harris hip score and Barthel Index score were significantly higher at 1, 3, and 6 months postoperatively than at discharge in both groups (p < 0.05). The Harris hip score and Barthel Index score at discharge and 1, 3, and 6 months postoperatively were significantly higher in the experimental group than in the control group (p < 0.05). The incidence of complications at 6 months postoperatively was significantly lower in the experimental group than in the control group (13% vs. 37%).

CONCLUSIONS

Rehabilitation therapy based on exercise prescription helps improve hip function and the ability to perform activities of daily living and related postoperative complications after hip fracture surgery in elderly patients. The findings of our study will guide decision-making in clinical practice and improve the clinical management of hip fractures in elderly patients postoperatively.

Extreme temperature exposure and urolithiasis: A time series analysis in Ganzhou, China

Background

Ambient temperature change is a risk factor for urolithiasis that cannot be ignored. The association between temperature and urolithiasis varies from region to region. Our study aimed to analyze the impact of extremely high and low temperatures on the number of inpatients for urolithiasis and their lag effect in Ganzhou City, China.

Methods

We collected the daily number of inpatients with urolithiasis in Ganzhou from 2018 to 2019 and the meteorological data for the same period. The exposure-response relationship between the daily mean temperature and the number of inpatients with urolithiasis was studied by the distributed lag non-linear model (DLNM). The effect of extreme temperatures was also analyzed. A stratification analysis was performed for different gender and age groups.

Results

There were 38,184 hospitalizations for urolithiasis from 2018 to 2019 in Ganzhou. The exposure-response curve between the daily mean temperature and the number of inpatients with urolithiasis in Ganzhou was non-linear and had an observed lag effect. The warm effects (30.4°C) were presented at lag 2 and lag 5-lag 9 days, and the cold effects (2.9°C) were presented at lag 8 and lag 3-lag 4 days. The maximum cumulative warm effects were at lag 0-10 days (cumulative relative risk, CRR = 2.379, 95% CI: 1.771, 3.196), and the maximum cumulative cold effects were at lag 0-5 (CRR = 1.182, 95% CI: 1.054, 1.326). Men and people between the ages of 21 and 40 were more susceptible to the extreme temperatures that cause urolithiasis.

Conclusion

Extreme temperature was correlated with a high risk of urolithiasis hospitalizations, and the warm effects had a longer duration than the cold effects. Preventing urolithiasis and protecting vulnerable people is critical in extreme temperature environments.

Seasonally Dependent Change of the Number of Fractures after 50 Years of Age in Poland-Analysis of Combined Health Care and Climate Datasets

Aim: The incidence of fractures correlates with many independent and interrelated factors. The aim of the study was to examine trends in fracture incidence and to find possible reasons for changes. Materials and methods: A complete dataset of Polish population aged above 50 from the National Heath Fund—which is a single, state-owned payer for the health service procedures in Poland—covering the years between 2010 and 2015 was analyzed along with climate dataset. Results: The analysis indicated that there was a substantial and statistically significant decrease in the incidence of forearm and hip fractures (p = 0.007 and 0.007, respectively). On the other side, there was a statistically significant increase in incidence of humerus and lumbar fractures (p = 0.002, p < 0.001, respectively). The observed changes (especially decrease in forearm and hip fracture incidence) happened mostly in the cold season and were correlated to mean-temperature changes during the assessed time period. Conclusion: In the analysis based on the dataset obtained from fracture-related database collected in Poland in the years 2010−2015 in the population of patients over 50 years of age, we observed that the changes of fracture incidence during the observation period are associated with and may be dependent on the season (warmer versus colder) and on mean temperature increase during the observation period.

The need for location-specific biometeorological indexes in Taiwan

Objective

As most available biometeorological indexes were developed decades ago in western countries, the benefit of using these indexes to study the effect of weather on human health in modern eastern countries is questionable. This study aimed to reconfirm the effectiveness of applying these biometeorological indexes when analyzing demand for daily emergency ambulance services (EAS) in Taipei.

Methods

More than 370,000 EAS usage records were analyzed in this study. The records were first allotted into different time-series data by age, gender, triage level, and case nature (trauma/non-trauma) in order to represent different kinds of daily EAS demand. They were then regressed on biometeorological indexes [Apparent Temperature (AT) and Net Effective Temperature (NET)]; the indexes' additional descriptive power to describe the daily EAS demand over traditional weather factors was then assessed.

Results

No significant difference was observed in the descriptive powers in terms of effect on daily EAS demand of the biometeorological indexes and traditional weather factors. The largest improvement on the regression models' adjusted-R2 using NET and AT was only 0.008.

Conclusion

It may not be a good idea to make direct use of the biometeorological indexes developed in western countries decades ago. Taiwan should have a tailor-made biometeorological index for a better representation of its unique situation.

Effects and Interaction of Meteorological Factors on Pulmonary Tuberculosis in Urumqi, China, 2013–2019

Background

Most existing studies have only investigated the delayed effect of meteorological factors on pulmonary tuberculosis (PTB). However, the effect of extreme climate and the interaction between meteorological factors on PTB has been rarely investigated.

Methods

Newly diagonsed PTB cases and meteorological factors in Urumqi in each week between 2013 and 2019 were collected. The lag-exposure-response relationship between meteorological factors and PTB was analyzed using the distributed lag non-linear model (DLNM). The generalized additive model (GAM) was used to visualize the interaction between meteorological factors. Stratified analysis was used to explore the impact of meteorological factors on PTB in different stratification and RERI, AP and SI were used to quantitatively evaluate the interaction between meteorological factors.

Results

A total of 16,793 newly diagnosed PTB cases were documented in Urumqi, China from 2013 to 2019. The median (interquartile range) temperature, relative humidity, wind speed, and PTB cases were measured as 11.3°C (−5.0–20.5), 57.7% (50.7–64.2), 4.1m/s (3.4–4.7), and 47 (37–56), respectively. The effects of temperature, relative humidity and wind speed on PTB were non-linear, which were found with the “N”-shaped, “L”-shaped, “N”-shaped distribution, respectively. With the median meteorological factor as a reference, extreme low temperature was found to have a protective effect on PTB. However, extreme high temperature, extreme high relative humidity, and extreme high wind speed were found to increase the risk of PTB and peaked at 31.8°C, 83.2%, and 7.6 m/s respectively. According to the existing monitoring data, no obvious interaction between meteorological factors was found, but low temperature and low humidity (RR = 1.149, 95%CI: 1.003–1.315), low temperature and low wind speed (RR = 1.273, 95%CI: 1.146–1.415) were more likely to cause the high incidence of PTB.

Conclusion

Temperature, relative humidity and wind speed were found to play vital roles in PTB incidence with delayed and non-linear effects. Extreme high temperature, extreme high relative humidity, and extreme high wind speed could increase the risk of PTB. Moreover, low temperature and low humidity, low temperature and low wind speed may increase the incidence of PTB.