AB0828 INFLUENCE OF SEASONAL VARIATIONS ON EMERGENCY RHEUMATOLOGY CONSULTATIONS
Authors: Z. El Ouali, R. Assadi, S. Lahrichi, K. Nassar, S. Janani
Journal: Annals of the Rheumatic Diseases (2021)

Background: The influence of the seasons on the onset of diseases has been demonstrated in epidemiological studies, particularly in infectious pathologies. In rheumatology, recent studies have suggested the role of seasons in the disease activity of rheumatoid arthritis (1,2). However, no epidemiologic data exist on the influence of seasons in urgent rheumatology consultations, all causes combined. Objectives: To study the influence of seasonal variations on urgent rheumatology consultations received in the Department of Rheumatology of the University Hospital of Ibn Rochd in Casablanca. Methods: We conducted a retrospective study on the 2019 emergency consultations register of the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. The seasons were divided as follows: winter from December to February, spring from March to May, summer from June to August, and fall from September to November. The studied parameters were age, sex, reasons for consultation, affected joints, and diagnoses. Results: 407 emergency consultations were carried out, with an average patient age of 50.7 years (range 14 - 88), and a sex ratio M/F of 0.4. The characteristics of the patients throughout the seasons is summed up in Table 1. The distribution of consultations by season was as follows: 29.5% in winter, 26.3% in spring, 25.4% in summer, and 18.8% in fall. The average age of the consultants depending on the season was homogeneous. The most frequent reasons for emergency consultation were respectively back pain (48.6%), polyarthralgia (23.1%), followed by arthritis (12.0%). Back pain slightly predominant in the cold seasons (fall, winter). Polyarthralgias had a winter peak. Arthritis presented a bimodal distribution in seasons of transition (spring, fall). The knees and lumbar spine were the most frequently involved joints throughout the year, with no major differences between the seasons. The most frequent diagnoses over the year were degenerative (51%), inflammatory (8.6%), infectious (7.3%), metabolic (6.7%), and tumor (2.1%) pathologies, respectively. %). Osteoarthritis flares were less frequent in spring and summer. Inflammatory pathologies have not experienced a seasonal peak. Gout flares and infectious pathologies peaked in the spring. Finally, tumor pathologies peaked in the fall. Conclusion: Seasonal variations seem to have an impact on the distribution of the reasons for consultation as well as the diagnoses made in the context of the rheumatologic emergencies. The cold seasons seemed to favor the onset of back pain and polyarthralgia, while the seasons of transition were conducive to the development of arthritis. References: [1]Mori H, Sawada T, Nishiyama S, Shimada K, Tahara K, Hayashi H, et al. Influence of seasonal changes on disease activity and distribution of affected joints in rheumatoid arthritis. BMC Musculoskelet Disord. 2019 Dec;20(1):30. [2]Azzouzi H, Ichchou L. Seasonal and Weather Effects on Rheumatoid Arthritis: Myth or Reality? Pain Research and Management. 2020 Sep 7;2020:1–5. Table 1. Characteristics of the patients throughout the seasons Winter n = 120 (29.5%) Spring n = 107 (26.3%) Summer n = 104 (25.4%) Fall n = 76 (18.8%) Total n = 407 (100%) Age 51,2 (16 – 86) 51,6 (14 – 84) 51,3 (16 – 88) 48 (16 – 79) 50,7 (14 – 88) Sex-ratio M/F 0,25 0,44 0,6 0,36 0,4 Reasons for consultation Arthritis (%) 8,3 15 11,5 14 12,0 Polyarthritis (%) 30 21,5 20,2 18,5 23,1 Back pain (%) 51.7 44.9 45.2 54.0 48.6 Joint involvement Shoulder (%) 33,3 21,5 22,1 22,4 27,2 Hand (%) 16,7 20,0 15,4 13,2 16,5 Knee (%) 49,2 41,0 48,1 46,1 46,2 Ankle (%) 13,3 14,0 13,5 14,5 13,8 Cervical spine (%) 6,0 10,3 9,6 7,9 8,4 Lumbar spine (%) 44,2 39,3 38,0 47,0 41,8 Diagnoses Osteoarthritis (%) 53,4 43,9 47,5 56,8 50,2 Knee osteoarthritis (%) 31,5 22,8 28,8 38,6 30,0 Lumbar osteoarthritis (%) 28,8 22,8 30,5 31,8 28,3 Septic (%) 2.7 7.0 1.7 2.3 3.4 Gout (%) 5.5 10.5 5.1 6.8 6.7 Inflammatory (%) 9.6 8.8 6.7 6.8 9.9 Tumor (%) 1.3 1.8 1.7 4.5 2.1 Disclosure of Interests: None declared