PRSonally Speaking

Tuesday, January 14, 2014

Articles of Interest Sneak Peak: Variation in the Incidence of Distal Radius Fractures in the US Elderly as Related to Slippery Weather Conditions
At least twice a month, PRSonally Speaking posts full abstracts of interesting or potentially controversial articles from a future issue. This 'sneak preview' of a hot article is meant to give you some food for thought and provide you with topic for conversation among colleagues.
When the article is published in print with the February issue, it will be FREE for a period of Two Months, to help the conversation continue in the PRS community and beyond. So read the abstract, join the conversation and spread the word.
This week we present the introduction to "Variation in the Incidence of Distal Radius Fractures in the US Elderly as Related to Slippery Weather Conditions" by Chung et al.

Background: Distal radius fractures (DRFs) are costly and debilitating injuries, especially for the elderly. DRFs often occur from falls and more commonly occur outdoors. Inclement weather, especially in the winter, may increase the risk of fall-related injuries. Small community studies have reported increased risk of DRF due to inclement winter weather; however, larger studies are lacking.

Methods: We analyzed a sample of 2007 Medicare claims for DRF. Weather data were collected for the date and location of each DRF in our analysis cohort. A novel slipperiness score (0-7, 7 indicates the most slippery weather) was used as a measure of the severity of slippery outdoor conditions. Negative binomial regression models evaluated the correlation between slipperiness and DRF occurrence.

Results: Risk of DRF was higher in winter months (Incidence Rate Ratio=1.2, 95%CI 1.14-1.26, p<0.001). Days with average temperature ≤ 32ºF (IRR=1.36, 95%CI 1.19-1.54, p<0.001), snow/ice on ground at the start of the day (IRR=1.45, 95%CI 1.25-1.68, p<0.001), and freezing rain (IRR=1.24, 95%CI 1.03-1.49, p=0.025) all had an increased risk of DRF. Risk of sustaining a DRF was increased 21% on days with a slipperiness score of 5 or above (IRR=1.21, 95%CI 1.08-1.20, p=0.007). Additionally, for each increase in slipperiness score above 4, the IRR of DRF increased as well.

Conclusions: Weather events that create slippery walking conditions, most often occurring in winter months, result in an increased risk of DRF in the US elderly. This finding can be used to support resource allocation as well as awareness and prevention campaigns.
The full article will be published with the February 2014 issue of PRS, and will be free online for non-subscribers. Until then, we hope this "sneak peek" will pique your interests and start a healthy, meaningful conversation.