Maxwell C J, Neutel C I, Hirdes J P
Clinical Epidemiology Unit, SCO-Elisabeth Bruyère Pavilion, Ottawa, Ontario K1N 5C8, Canada.
Pharmacoepidemiol Drug Saf. 1997 Jan;6(1):27-35. doi: 10.1002/(SICI)1099-1557(199701)6:1<27::AID-PDS240>3.0.CO;2-S.
Although research has consistently demonstrated an increased risk for falls and fall-related fractures among persons receiving benzodiazepine (BZD) medications, the association between new as compared with chronic use and fall-related morbidity among different age groups is less clear. The objectives of this prospective cohort study were to examine the associations between BZD sedative and tranquillizer use and fall-related hospitalizations within 28 days of the fill date, and to explore variations in risks among new (after the first prescription) and chronic (after the third prescription) BZD users of different ages. Data were derived from the Saskatchewan Health linked databases for the years 1979-1986. Fall rates increased with age (especially beyond 70 years) and were highest among those receiving BZD sedatives and tranquillizers compared with controls for both new and chronic users. After adjusting for age, sex and selected health and social factors, a significantly increased risk of fall-related hospitalization was found among new BZD sedative (OR=2.8) and tranquillizer (OR=2.0) users compared with controls, and this risk was only slightly reduced among chronic BZD sedative (OR=2.4) and tranquillizer (OR=1.6) users. These risk estimates were consistent across age, with the exception that chronic BZD tranquillizer use remained significant only among those aged 70 years and older.
尽管研究一直表明，服用苯二氮䓬（BZD）类药物的人跌倒及与跌倒相关骨折的风险会增加，但新使用者与长期使用者相比，以及不同年龄组中与跌倒相关的发病率之间的关联尚不清楚。这项前瞻性队列研究的目的是，调查开具日期起28天内BZD镇静剂和安定药的使用与跌倒相关住院之间的关联，并探究不同年龄的新使用者（首次处方后）和长期使用者（第三次处方后）的风险差异。数据来源于1979年至1986年萨斯喀彻温省卫生关联数据库。跌倒发生率随年龄增长而增加（尤其是70岁以上），在新使用者和长期使用者中，服用BZD镇静剂和安定药的人跌倒发生率高于对照组。在对年龄、性别以及选定的健康和社会因素进行调整后，发现新的BZD镇静剂使用者（OR=2.8）和安定药使用者（OR=2.0）与对照组相比，跌倒相关住院风险显著增加，而长期BZD镇静剂使用者（OR=2.4）和安定药使用者（OR=1.6）的这种风险仅略有降低。除了长期使用BZD安定药仅在70岁及以上人群中仍具有显著风险外，这些风险估计在各年龄组中是一致的。
