# Evaluation of Seasonal and Climatic Variations Associated With Femoral Fracture Incidence Among the Elderly Population in Brazil

## TL;DR

This study finds that femur fractures in elderly people in Brazil are more common during colder months, suggesting a link between lower temperatures and increased fracture risk.

## Contribution

The study identifies a seasonal pattern in femur fracture incidence among the elderly in Brazil, linked to temperature variations.

## Key findings

- Femur fracture incidence peaks during Brazil's winter months (June to August) when temperatures are lowest.
- Lower temperature ranges (22-23°C) correlate with significantly higher fracture rates compared to warmer ranges (25-26°C).

## Abstract

Introduction: Femur fractures represent a significant public health concern for individuals over 60 years of age. In Brazil, the incidence of these fractures has shown a rising trend in line with population aging. Besides intrinsic risk factors like osteoporosis, seasonal and climatic variables have been suggested to significantly influence the occurrence of these fractures.

Methods: Epidemiological data were sourced from the Hospital Information System of the Unified Health System (SIH-SUS) using the TABNET tool provided by the Department of Informatics of the Unified Health System (DATASUS). Information on hospital admissions for femur fractures in individuals over 60 years, categorized by diagnosis, region, and month, was collected from 2008 to 2023. Climatic data were obtained from the Brazilian National Institute of Meteorology (INMET) for the period from 1991 to 2020. Monthly average temperatures were compared with epidemiological data and analyzed to uncover correlations using ANOVA and Tukey's honestly significant difference (HSD) test.

Results: During Brazil's winter months (June to August: 22.8 to 23.5º Celsius), average temperatures are at their lowest. This period also coincides with the peak incidence of femur fractures among the elderly. ANOVA revealed significant differences in fracture rates across various temperature ranges. Subsequent analysis using Tukey’s HSD test identified significant differences between temperature ranges of 22-23°C and 25-26°C, as well as 23-24°C and 25-26°C. These results indicate that lower temperatures are associated with a higher incidence of femur fractures among the elderly.

Conclusion: The analysis reveals a seasonal pattern in fracture incidence among older adults, with a notable increase during the colder months. To mitigate this risk, it is recommended to implement strategies such as heightened surveillance during colder months, targeted fall prevention measures, and effective osteoporosis management. These interventions aim to reduce the incidence of fractures in this vulnerable population.