Most Hip Fractures in Older Adults Occur in Warm Months and Indoors

    Think the shorter winter days, ice, and snow put older adults at greater risk for a fall and fractured hip?

    Think again.

    Results of a study presented at the ANESTHESIOLOGY 2017 annual meeting show that the majority of falls occur during warm months, and a greater number of the falls happen indoors rather than outdoors.

    “Falls are one of the most common health concerns facing the elderly today,” said study author Jason Guercio, MD, MBA, from North American Partners in Anesthesiology at The Hospital of Central Connecticut in New Britain.

    “And this population is the fastest growing segment of the US. People 65 and older are predicted to more than double in number by 2050, increasing from 39 million to 89 million. Falls leading to fracture can result in disability and even death. Understanding the risk factors for fractures can help to focus efforts on decreasing them, and guide resources and appropriate interventions to prevent them.”

    The researchers included 544 patients treated for hip fracture between 2013 and 2016 at The Hospital of Central Connecticut in their retrospective observational study, recording the time of year when the fracture occurred and whether the incident causing the fracture happened indoors or outdoors. They defined “cold” months as November 1 through April 30, and “warm” months as May 1 through October 31.

    More than 55% of hip fractures occurred during warm months, with the highest proportion of fractures occurring in May (10.5%), September (10.3%) and October (9.7%). And although the fractures were spread fairly evenly throughout the year, the authors found the majority (76.3%) of hip fractures occurred indoors, with only 23.6% occurring outside. Of the outdoor fractures, more than 60% of them happened during warm months. For fractures that occurred indoors, more than 56% happened during warm months.

    The most common incident leading to hip fracture was tripping over an obstacle (43.3% for indoors and 57.1% for outdoors). Inside the home, the most common obstacle appeared to be throw rugs. For indoor fractures, the second leading cause was falling out of bed. For outdoor fractures, the second and third leading causes were being struck by or falling from a vehicle or falling on or down stairs.

    “It is counterintuitive that the risk for hip fracture would be higher in warm months, as ice and snow would appear to be significant fall risks,” Dr. Guercio said. “Given the results of this study, it appears that efforts to decrease fall risk among the elderly living in cold climates should not be preferentially aimed at preventing outdoor fractures in winter, but should focus on conditions present throughout the year, and most importantly on mitigating indoor risk.”


    Guercio JR, La Porta J-R, DiFrancesco AA, Weintraub S. Frailty Hip Fracture in the Elderly Does Not Display Seasonal Variation in a New England Hospital (abstract A3174). Presented at ANESTHESIOLOGY 2017, October 21-25, 2017, Boston, Massachusetts.