Orthopedic Resources and Education

Influence of Season and Weather on Adult Orthopaedic Trauma Volume and Severity

Arthur E. Hess, MD, Mark S. Vrahas, MD, Suzanne M. Morrison, MPH, Amber M. Hall, MS, David Zurakowski, PhD, Micheal J. Weaver, MD

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Abstract

BACKGROUND To determine seasonal variability and influence of weather on adult orthopaedic trauma volume at two American College of Surgeons (ACS) Level I trauma centers in New England.
METHODS Adult orthopaedic injuries consisting of extremity and pelvic fractures and dislocations over a five-year period were examined for seasonal trends in both total orthopaedic volume and open fracture volume. We looked for variability dependent on weather conditions including maximum daily temperature, precipitation, and projected daylight hours.
RESULTS Seasonal variation in both total volume of injuries and open fractures was observed. There was higher average volume of total injuries in the winter (937 ± 79) and summer (982 ± 87) months compared to spring (826 ± 46) and fall months (893 ± 54; p<0.001). Higher maximum daily temperatures were correlated with more injuries, with average injuries per day highest in the hottest quartile days (10.0 ± 4.6). Similarly, more open fractures occurred in the hotter quartile days. With every 5 degree rise in maximum temperature, the odds of an injury being open increased by 10%. Precipitation had no effect on total volume, but was weakly correlated with a decreased volume of open fractures (r=-0.06). Number of daylight hours had a small effect on both total volume and number of open fractures, but this correlation was also weak (r=0.113).
CONCLUSION In New England, there is seasonal variability in adult orthopaedic trauma with higher volume and open fractures occurring in the summer months. Higher ‘temperatures and longer days were predictive of higher volume of total injuries and open fractures.
LEVEL OF EVIDENCE Prognostic Level III
KEYWORDS Weather, trauma, volume, fracture, precipitation