A year’s trauma admissions and the effect of the weather

doi:10.1016/j.injury.2003.10.027

Injury

Volume 36, Issue 1, January 2005, Pages 40-46

https://doi.org/10.1016/j.injury.2003.10.027 Get rights and content

Abstract

Purpose of the study: To study the admissions to a busy trauma unit on a day-by-day basis over a 1 year period, and to look for any correlation with local weather variation or temporal factors (day of the week, weekends/school holidays, etc.). Method: Admissions data for the Trauma Unit at the Leicester Royal Infirmary was collected from an administrative database and ward records for the calendar year of 1998. Admissions were split into four groups: all admissions, adult admissions, admissions for proximal femoral fractures (neck of femur (NOF)) and paediatric admissions.

Weather information for the local area was obtained from the Meteorological Office. Details of school holidays were obtained from the local Education Department.

The above variables were examined using Poisson regression analysis for their potential importance in explaining day-to-day variation in admission rates for the four groups. Results: For adult and NOF admissions, none of the weather factors appeared to explain variation in incidence, only day of the week appears to be important, with the earlier part of the week yielding a highly statistically significant increase in the relative incidence of trauma admissions.

For both paediatric and total admissions, a number of factors appear important, including maximum and minimum temperatures, hours of sunshine, day of the week and month of the year. Daily rainfall, significant weather and whether the day was a school day or school holiday did not appear to be important on univariate analysis. Conclusion: Trauma admissions are related to both weather and temporal factors. This may have implications both in terms of prevention and in planning of care provision in trauma units.

Introduction

One of the major problems encountered in the provision of trauma services is in trying to allow for the variability of admission numbers. One factor commonly perceived to be important is the weather on the day of admission. We decided to investigate the presence and nature of any such link.

The Leicester Royal Infirmary is one of the busiest trauma units in the country—serving a catchment population of 1.1 million, served by a single Accident & Emergency Department (A&E) with visits at around 110,000 per year, and around 3000 admissions to acute trauma beds per annum.

Section snippets

Method

Trauma admission data was collected for the period 1 January 1998–31 December 1998. These were analysed on a day-to-day basis. Only admissions to Inpatient beds were examined. Admissions with diagnoses other than definite trauma, such as infections, non-traumatic back pain, ‘irritable hips’, etc. were not included. Admissions were either via the Accident & Emergency Department or via the general practitioner (GP)—planned admissions via Fracture Clinic (and therefore ‘non-acute’) were also

Statistical analysis

Using Poisson regression analysis, various factors were explored for their potential importance in explaining day-to-day variation in admission rates for (a) total; (b) adult total; (c) adult neck of femur; and (d) paediatric orthopaedic trauma admissions. A multivariate model for each of the four outcomes was developed using a forward stepwise model selection procedure with a 5% statistical significance entry criteria.

In order to assess whether there was evidence of serial correlation in the

Results

A total of 2914 patients were admitted during the study period, 2279 adults and 635 children. Of those adults, 693 were with a diagnosis of fractured neck of femur (NOF). Thus, an ‘average’ day’s admissions approximate to eight, of whom six were adults and two children. Of the six adults, two would have a fractured NOF.

The mean daily admissions were 7.98. The range was widespread, from several days with no admissions at all, to a maximum of 22.

Initially, data was plotted on simple cumulative

Discussion

We have analysed admission data to a busy trauma unit on a day-to-day basis over a period of 1 year. Two thousand nine hundred and fourteen (2914) patients were identified for the database. The effects of a variety of weather and temporal factors were examined and various correlations found.

The total admission numbers rose over the summer months—this trend was largely explained by a corresponding rise in paediatric admissions. Increased daily temperatures, more hours of sunshine and fewer

Conclusion

Trauma admissions are related to both weather and temporal factors. Weather factors appear particularly important for paediatric trauma admissions. Adult (and more specifically fractured neck of femur) admissions appear to be related to days of the week.

These findings may have implications both in terms of prevention and in planning of care provision in trauma units.

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Citation Excerpt :
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A year’s trauma admissions and the effect of the weather

Abstract

Introduction

Section snippets

Method

Statistical analysis

Results

Discussion

Conclusion

Aust. J. Public Health

Injury

Effect of season on physical activity score, back extensor muscle strength, and lumbar bone mineral density

J. Bone Miner. Res

Falls, elderly women and the cold

Gerontology

Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study

Age Aging