UCalgary researchers analyze relationship between weather patterns and orthopedic trauma surgery volume

We know walking across an icy parking lot after a snowfall increases the risk of a slip that could result in injury or worse — a visit to the emergency room. But how much does it increase risk?

A study published in Injury reveals drastic increases in orthopedic trauma surgery volumes during the winter months, causing significant burdens to the health-care system and longer wait times for patients requiring urgent orthopedic surgery.

Dr. Neil White, MD, orthopedic surgeon and assistant professor in the Cumming School of Medicine, and Martina Vergouwen, Faculty of Nursing student, used a comprehensive dataset to identify the relationship between weather variables, time of year, and orthopedic trauma surgery levels in Calgary. Their findings led them to create a predictive ice model to forecast increases in surgery due to weather and the overall risk of falling.

Anticipating an increase in orthopedic trauma surgeries

The research team reviewed 11 years of data on trauma surgical orthopedic cases (nearly 41,000 cases) from Calgary hospitals and weather information from the Calgary International Airport and Government of Alberta Road Weather Information System (RWIS) sensors. With help from a meteorologist, David Spence, the team created the ice model using air and surface temperature and precipitation levels and then compared the weather data with past orthopedic trauma surgery volumes.

The findings revealed that weather patterns in Calgary affected both the volume and nature of orthopedic trauma. For example, the data linked a spike in hip and ankle injuries on the same days as winter snowstorms.

“What we discovered by analyzing the data is that time of year plays a significant role. In knowing that it is January, we can predict it will be busy, but when we add snow and ice conditions, we see surges that can overwhelm our hospital resources,” explains White.

Using the ice model, the researchers evaluated same-day weather and the impacts of compounding variables such as surface temperature, snow, and previous days’ weather conditions on ice formation to determine which weather conditions were related to surgical orthopedic trauma volumes. 

Their analysis found that their ice model predicted higher orthopedic trauma volumes, including slip and fall accidents. For example, ice for three consecutive days and same-day snow was predictive of a 37 per cent increase in the volume of orthopedic trauma surgery.

When there is a surge in the volume of orthopedic trauma requiring surgery, there are consequent increases in operative workload and after-hour surgery demands, increasing wait times which can impact complications following surgery.  

“Although operating room resources are consistent all year, one way to better prepare for an expected surge in orthopedic surgical volumes is to schedule fewer elective surgeries in the predictive busy months to free up space for increases in trauma surgery and instead offer more elective surgery in the low trauma seasons,” White says. “By matching our trauma resources to patients’ needs, we can help efficiently use resources and staffing to decrease wait times and stress on our operating rooms.”

Building an injury prevention strategy

Analyzing these highly predictive variables, the researchers developed a slip and fall index, adding other variables such as fresh snow on the ground coupled with ice conditions to calculate the overall risk of falling on ice and potential for serious injury.

“With the slip and fall index, we can calculate the risk as very high or very low by accounting for multiple weather variables and previous days’ conditions,” says Vergouwen, lead author on the study. “We hope to eventually use the data as a way to prevent injuries by informing the public of their increased risk of falling while walking outside on any given day.”

Future direction for the research includes validating the data using similar climates and using the data as a public health tool. The goal is to use the data as part of an injury prevention strategy to inform the public about risk levels and design intervention options such as presenting available food delivery options during a high-risk period and encouraging wearing cleats to reduce the likelihood of slipping on ice.

“At the system level, it is important to minimize orthopedic trauma surges, but it is equally important for individuals to avoid breaking their ankle or hip. If we can reduce five to 10 per cent of trauma surgeries by preventing injuries and falls, the impact is massive on people’s well-being and to the health system overall,” says Vergouwen.