Session VIII - General Interest

Sat., 10/12/13 Topics of General Interest, PAPER #92, 1:16 pm OTA 2013

Nature’s Wrath: The Effect of Daily Weather Patterns on Postoperative Pain Following Orthopaedic Trauma

Brandon S. Shulman, BA1; Alejandro I. Marcano, MD1; Roy I. Davidovitch, MD1;
Raj J. Karia, MPH1; Kenneth A. Egol, MD1,2;
1NYU Hospital for Joint Diseases, New York, New York, USA;
2Jamaica Medical Center, Jamaica, New York, USA

Background/Purpose: The effect of weather on patients’ pain and mobility is a frequent complaint in all aspects of musculoskeletal care. While there has been limited investigation into the effects of weather on arthritis and various medical pathologies, to our knowledge there are no data regarding weather’s effect on orthopaedic trauma patients’ complaints of pain following acute and chronic fracture. The aim of our study was to investigate the influence of daily weather conditions on patient-reported pain and functional status.

Methods: We examined 2369 separate outpatient visits of patients recovering from operative management of an acute tibial plateau fracture (n = 332), an acute distal radius fracture (n = 1179), or chronic fracture nonunion (n = 858). At each outpatient visit, patients were asked to report their pain on a scale of 0 to 10. Functional status was recorded using the DASH (Disabilities of the Arm, Shoulder and Hand) or SMFA (Short Musculoskeletal Function Assessment). For each individual patient visit date, we then recorded the mean temperature, difference between the mean temperature and expected temperature based on a 17-year average, dew point, mean humidity, amount of rain, amount of snow, barometric pressure, and wind speed. All weather data were specific to the zip code of the outpatient medical office where patients were seen, and obtained from a publicly available almanac. Statistical analysis was run to search for correlations between weather data and patient-reported pain scores and functional status.

Results: There was a highly significant association between low barometric pressure (calculated as below one standard atmosphere or 29.92 in) and increased pain for patients at 1-year follow-up only (P = 0.006), and a trend toward association between low barometric pressure and increased pain for all patient visits (P = 0.072). At 1-year follow-up, temperatures above 35°F (P = 0.018) and humidity above 70% (P = 0.001) were also significantly associated with increased pain. No other weather data had significant correlation with patient-reported pain scores. No significant association was noted between weather data and patient-reported functional status (as calculated by the DASH or SMFA functional indexes).

Conclusion: While pain in the immediate postoperative period is most likely dominated by incisional and soft-tissue injuries, as time progresses weather clearly impacts patient pain levels. Variation in patient-reported pain scores due to weather conditions should be anticipated. Patients may be counseled that their symptoms may worsen in association with weather conditions.

Alphabetical Disclosure Listing

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.