Archives of Osteoporosis

, 13:28 | Cite as

Weather conditions and their effect on seasonality of incident osteoporotic hip fracture

  • Ramón MazzucchelliEmail author
  • Natalia Crespí-Villarías
  • Elia Pérez-Fernández
  • María Luz Durbán Reguera
  • Olalla Guzón Illescas
  • Javier Quirós
  • Alberto García-Vadillo
  • Loreto Carmona
  • Gil Rodriguez-Caravaca
  • Angel Gil de Miguel
Original Article



Our aim was to analyze the seasonality and the effect of weather conditions on the incidence of osteoporotic hip fracture in a Southern European region.


The objective of this work is to evaluate seasonality and the effect of weather conditions on the incidence of osteoporotic hip fracture in a Southern European region.


This retrospective cohort study included all patients admitted to Alcorcón Foundation University Hospital with a diagnosis of osteoporotic hip fracture between the years 1999 and 2015. In a time series analysis, we examined the association between hip fracture incidence and different weather conditions and seasonality using general additive models (with Poisson distribution). The incidence rate ratio (IRR) crude and adjusted by season was estimated for all parameters. Hip incidence was further analyzed by sex and age (below or over 75) subgroups.


Four thousand two hundred seventy-one patients with an osteoporotic hip fracture were included (79% females, mean age 83.8). Season fracture rate was significantly higher in fall and winter (67.06 and 64.41 fractures/season) compared to summer and spring (59.71 and 60.06; p < 0,001). Hip fracture incidence was 15% greater in autumn and winter than in spring and summer. Fog [IRR 1.15 (95% CI: 1.003–1.33)], atmospheric pressure (per 100 mb) [IRR 1.05 (95% CI: 1.004–1.114)], and frost [IRR 1.15 (95% CI: 1.03–1.30)] were significantly associated with increased hip fracture. Haze [IRR 1.10 (95% CI: 0.99–1.23)] showed a trend without statistical significance. Daily average temperature (per 5 °C) [IRR 0.98 (95% CI: 0.957–0.996)], rain (per 10 ml) [IRR 0.99 (95% CI: 0.981–1.0)], wind speed [IRR = 0.952, (95% CI: 0.907–0.998)], and daily ultraviolet radiation (per 100 joules) [IRR 0.998 (95% CI: 0.996–1.0)] were negatively associated with fracture. After adjusting by season and trend, all these associations disappear.


In this Southern region, hip fracture incidence exhibits a seasonal pattern different from those communicated in Northern regions. There is short-term association with different weather conditions that partly explain this seasonal pattern.


Hip fracture Weather Climatological variables Seasonality Osteoporosis Spain 



Basic minimum data set


Conjunto Mínimo Básico de Datos


International Classification of Diseases, 9th Clinical Modification


State Meteorological Station


post meridiam


day of year


Generalized additive models


standard deviation

95% CI

95% confidence interval


Incidence rate ratio





We thank the staff of State Meteorological Station (AEMET) for contributing with the meteorological data and their contribution in the discussion of the results.

Authors’ contributions

RM conceived the study, developed study methods, and prepared the study data. EPF performed the analyses. MLDR advised on the analysis of the data. NCV, AGV, OG, and JQ reviewed the paper and provided comments and edits. RM and LC wrote the manuscript. All authors have read and approved the manuscript.


Publication fees were provided by Abbvie Lab. The funding bodies played no role in any aspect of the study (study design, data collection, analysis, or interpretation or writing of the manuscript).

Compliance with ethical standards

Conflict of interest


Ethics approval and consent to participate

This study has been approved by the Ethics Committee of the Alcorcón Foundation University Hospital.

Availability of data and materials

The study was performed using publicly available data as described in the text. The datasets used and analyzed during the current study are available from the original sources or from the corresponding author on reasonable request.

Supplementary material

11657_2018_438_ESM1_ESM.docx (68 kb)
ESM 1 (DOCX 67 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Ramón Mazzucchelli
    • 1
    Email author
  • Natalia Crespí-Villarías
    • 2
  • Elia Pérez-Fernández
    • 3
  • María Luz Durbán Reguera
    • 4
  • Olalla Guzón Illescas
    • 5
  • Javier Quirós
    • 1
  • Alberto García-Vadillo
    • 6
  • Loreto Carmona
    • 7
  • Gil Rodriguez-Caravaca
    • 8
  • Angel Gil de Miguel
    • 8
  1. 1.Department of RheumatologyHospital Universitario Fundación AlcorcónMadridSpain
  2. 2.Centro de Salud La Rivota (Alcorcón)MadridSpain
  3. 3.Department of Clinical InvestigationHospital Universitario Fundación AlcorcónMadridSpain
  4. 4.Department of Statistics/Escuela Politécnica SuperiorUniversidad Carlos III de MadridMadridSpain
  5. 5.Department of RehabilitationHospital Universitario Fundación AlcorcónMadridSpain
  6. 6.Department of RheumatologyHospital Universitario de la PrincesaMadridSpain
  7. 7.Instituto de Salud Musculoesquelética (InMusc)MadridSpain
  8. 8.Department of Preventive Medicine and Public HealthUniversidad Rey Juan CarlosMadridSpain

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