Advertisement

The influence of heatwave temperatures on fracture patient presentation to hospital

      Highlights

      • There is currently very limited data in the present literature, which assesses the effects of heatwave temperatures on fracture patient presentation to hospital.
      • Our study design allowed for a robust assessment of the effects of heatwave temperatures on fracture patient presentation to hospital, in our hospital catchment population and in our Major Trauma Network population.
      • Temperature and humidity data were included in our study, allowing both to be assessed, in terms of their influence on fracture patient presentation to hospital.
      • Our findings showed that heatwave temperatures resulted in a significantly increased number of orthopaedic polytrauma patients presenting to a Major Trauma Centre.

      Abstract

      Introduction

      As global warming continues at its current rate, heatwaves are likely to become an increasing phenomenon. At present, knowledge of the influence of heatwave temperatures on fracture patient presentation to hospital remains limited.

      Methods

      This was a retrospective descriptive epidemiology study performed through hospital database review, linked to meteorological data. Emergency Department and Fracture Patient Presentation Data was obtained for the adult (16+) South Glasgow population (population count – 525,839) and the adult (16+) population covered by the West of Scotland Major Trauma Centre (population count – 2,218,326) from May 2021 to August 2021. This was combined with maximum temperature data, along with humidity and humidex data. Humidex is a measure which quantifies the temperature experienced by the patient, through a combined score incorporating both maximum temperature and humidity

      Results

      During the study period, there was one temperature heatwave (19th to 25th July), and four humidex heatwaves (27th June to 3rd July, 15th to 17th July, 19th to 27th July, 22nd to 26th August). During the temperature heatwave, there was a significantly higher incidence of orthopaedic polytrauma patient presentation (IRR 2.37: p < 0.027), as well as ED patient presentation (IRR 1.07: p < 0.036). The humidex heatwaves were associated with a significantly higher incidence of orthopaedic polytrauma patient presentation (IRR 2.31: p < 0.002) and overall fracture patient presentation (IRR 1.18: p < 0.002).
      Positive correlations were found between orthopaedic polytrauma patient presentation vs temperature (R=0.217: p < 0.016), ED patient presentation vs temperature (R=0.427: p < 0.001), fracture patient presentation vs temperature (R=0.394: p < 0.001), and distal radius fracture patient presentation vs temperature (R=0.246: p < 0.006).

      Conclusion

      This study finds that heatwave temperatures result in a significantly increased number of orthopaedic polytrauma patients presenting to a Major Trauma Centre. Given the significant resources these patients require for care, Major Trauma Centres should be aware of such findings, and consider staff and resources profiles in response.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. UN-Climate-Change-Conference-UK-2021. COP26 Explained. 2021.

        • Tong S.
        • Prior J.
        • McGregor G.
        • Shi X.
        • Kinney P.
        Urban heat: an increasing threat to global health.
        BMJ. 2021; 375: n2467
        • Khosla R.
        • Jani A.
        • Perera R.
        Health risks of extreme heat.
        BMJ. 2021; 375: n2438
      2. What is a heatwave? - Met Office [Available from: https://www.metoffice.gov.uk/weather/learn-about/weather/types-of-weather/temperature/heatwave.

      3. accuweather.com - Glasgow - July 2021 [Available from: https://www.accuweather.com/en/gb/glasgow/g3-8/july-weather/328226?year=2021.

        • Mastrangelo G.
        • Fedeli U.
        • Visentin C.
        • Milan G.
        • Fadda E.
        • Spolaore P.
        Pattern and determinants of hospitalization during heat waves: an ecologic study.
        BMC Public Health. 2007; 7: 200
        • Sun S.
        • Weinberger K.R.
        • Nori-Sarma A.
        • Spangler K.R.
        • Sun Y.
        • Dominici F.
        • et al.
        Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study.
        BMJ. 2021; 375e065653
        • Silberner J.
        Heat wave causes hundreds of deaths and hospitalisations in Pacific north west.
        BMJ. 2021; 374: n1696
        • Murray I.R.
        • Howie C.R.
        • Biant LC.
        Severe weather warnings predict fracture epidemics.
        Injury. 2011; 42: 687-690
        • Noordin S.
        • Masri BA.
        Vancouver winters: environmental influences on inpatient adult orthopaedic trauma demographics.
        J Pak Med Assoc. 2014; 64: 549-552
        • Ogliari G.
        • Ong T.
        • Marshall L.
        • Sahota O.
        Seasonality of adult fragility fractures and association with weather: 12-year experience of a UK fracture liaison service.
        Bone. 2021; 147115916
        • Ali A.M.
        • Willett K.
        What is the effect of the weather on trauma workload? A systematic review of the literature.
        Injury. 2015; 46: 945-953
        • Vergouwen M.
        • Samuel T.L.
        • Sayre E.C.
        • White NJ.
        FROST: factors predicting orthopaedic trauma volumes.
        Injury. 2021; 52: 2871-2878
        • Johnson N.A.
        • Stirling E.
        • Dias J.J.
        The effect of mean annual temperature on the incidence of distal radial fractures.
        J Hand Surg Eur Vol. 2018; 43: 983-987
        • Rising W.R.
        • O'Daniel J.A.
        • Roberts CS.
        Correlating weather and trauma admissions at a level I trauma center.
        J Trauma. 2006; 60: 1096-1100
        • Wilson J.M.
        • Staley C.A.
        • Boden A.L.
        • Boissonneault A.R.
        • Schwartz A.M.
        • Schenker ML.
        The effect of season and weather on orthopaedic trauma: consult volume is significantly correlated with daily weather.
        Adv Orthop. 2018; 20186057357
        • Shukla R.
        • Jain N.
        • Agarwal U.
        • Sheikh T.
        • Jain R.
        Seasonal variation in orthopedic trauma patients-an experience from central India.
        J Clin Orthop Trauma. 2018; 9 (Suppl-S3): S40
        • Lund A.R.
        • Faergemann C.
        • Lauritsen JM.
        A population-based study of seasonal variation in children's fractures.
        Dan Med J. 2021; 68
        • Sinikumpu J.J.
        • Pokka T.
        • Sirnio K.
        • Ruuhela R.
        • Serlo W.
        Population-based research on the relationship between summer weather and paediatric forearm shaft fractures.
        Injury. 2013; 44: 1569-1573
        • Segal D.
        • Slevin O.
        • Aliev E.
        • Borisov O.
        • Khateeb B.
        • Faour A.
        • et al.
        Trends in the seasonal variation of paediatric fractures.
        J Child Orthop. 2018; 12: 614-621
        • Atherton W.G.
        • Harper W.M.
        • Abrams KR.
        A year's trauma admissions and the effect of the weather.
        Injury. 2005; 36: 40-46
        • Butcher N.E.
        • D'Este C.
        • Balogh Z.J.
        The quest for a universal definition of polytrauma: a trauma registry-based validation study.
        J Trauma Acute Care Surg. 2014; 77: 620-623
      4. postal-codes.cybo.com - G43 Postcode [Available from: https://postal-codes.cybo.com/united-kingdom/G43/.

      5. Scottish-Trauma-Network-West:-West-of-Scotland-Regional-Planning. 2020 mid-year population estimates. 2020.

      6. Scottish Trauma Network - West of scotland [Available from: https://www.scottishtraumanetwork.com/regions/west-of-scotland/.

      7. timeanddate.com - Weather - glasgow - May 2021 [Available from: https://www.timeanddate.com/weather/uk/glasgow/historic?month=5&year=2021.

      8. Canadian Humidex Calculator [Available from: http://www.csgnetwork.com/canhumidexcalc.html.

        • Campbell H.E.
        • Stokes E.A.
        • Bargo D.N.
        • Curry N.
        • Lecky F.E.
        • Edwards A.
        • et al.
        Quantifying the healthcare costs of treating severely bleeding major trauma patients: a national study for England.
        Crit Care. 2015; 19: 276
        • Scott C.E.H.
        • Holland G.
        • Powell-Bowns M.F.R.
        • Brennan C.M.
        • Gillespie M.
        • Mackenzie S.P.
        • et al.
        Population mobility and adult orthopaedic trauma services during the COVID-19 pandemic: fragility fracture provision remains a priority.
        Bone Jt Open. 2020; 1: 182-189
        • MacDonald D.R.W.
        • Neilly D.W.
        • Davies P.S.E.
        • Crome C.R.
        • Jamal B.
        • Gill S.L.
        • et al.
        Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland.
        Bone Jt Open. 2020; 1: 541-548
        • Rau C.S.
        • Wu S.C.
        • Kuo P.J.
        • Chen Y.C.
        • Chien P.C.
        • Hsieh H.Y.
        • et al.
        Polytrauma defined by the new berlin definition: a validation test based on propensity-score matching approach.
        Int J Environ Res Public Health. 2017; 14