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Background and Objectives : The incidence of hip fractures is increasing, and there have been reports linking cold weather to a higher risk of fractures. This study aimed to evaluate clinical variables in hip fracture patients who may predispose them to such fractures under different temperatures. Materials and Methods : This is a cross-sectional study conducted at a single medical center, enrolling older adults (≥60 years) who had experienced a hip fracture. Comprehensive clinical histories and detailed information regarding each patient's hip fracture were obtained. All meteorological data were extracted from the Taiwan Central Weather Bureau database. Multiple clinical parameters that may have a close connection with the temperature at which the hip fracture occurred were screened. Statistical analysis involved using the Pearson correlation test or the independent Student's t test, followed by generalized estimating equation analysis. Results : The cohort comprised 506 older adults with hip fractures. Initial univariate analysis revealed that a history of past cerebrovascular diseases, Charlson Comorbidity Index, patient age, and preinjury Barthel Index were significantly related to the temperature at which the hip fractures occurred. The generalized estimating equation analysis indicated that only the Charlson Comorbidity Index had a considerably inverse association with temperature. This finding suggests that for older adults with a higher Charlson Comorbidity Index, hip fractures tend to occur at lower temperatures and vice versa. Conclusions : Comorbidities are the only clinical concern that predisposes older adults to hip fractures under colder temperatures. This epidemiological finding could guide future patient education and hip fracture prevention programs.

Background and Objectives : Hip fractures in the elderly pose a considerable health risk and cause concern. Red blood cell distribution width (RDW) is a valuable marker for identifying patients at high risk of age-related mortality and various disorders and diseases. However, its association with poor patient outcomes following hip fractures has yet to be fully established. Hence, the purpose of this meta-analysis was to investigate and gain a better understanding of the relationship between RDW levels and the risk of mortality after hip fractures. Materials and Methods : PubMed, Embase, Web of Science, and other databases were comprehensively searched until April 2023 to identify relevant studies. The meta-analysis included observational studies finding the association between RDW at admission or preoperation and short-term and long-term mortality rates following hip fractures. The results were presented in terms of odds ratios (ORs) or hazard ratios (HRs) with corresponding 95% confidence intervals (CIs). Results : This meta-analysis included 10 studies involving 5834 patients with hip fractures. Patients with preoperative RDW of over 14.5% had higher risks of 1-year (OR: 5.40, 95% CI: 1.89-15.48, p = 0.002) and 3-month (OR: 2.91, 95% CI: 1.42-5.95, p = 0.004) mortality. Higher admission or preoperative RDW was significantly associated with an 11% higher mortality risk after 1 year (HR: 1.11, 95% CI: 1.06-1.17, p < 0.00001). Patients with higher preoperative RDW had a significantly higher risk of 6-month mortality, which was three times that of those with lower preoperative RDW (OR: 3.00, 95% CI: 1.60-5.61, p = 0.0006). Higher preoperative RDW was correlated to a higher 30-day mortality risk (OR: 6.44, 95% CI: 3.32-12.47, p < 0.00001). Conclusions : Greater RDW values at admission or before surgery were associated with a higher risk of short-term and long-term mortality following hip fractures. Because RDW can be easily measured using a routine blood test at a low cost, this parameter is promising as an indicator of mortality in elderly patients with hip fractures.