Hoffmann F, Glaeske G
Universität Bremen, Institut für Public Health und Pflegeforschung (IPP) AG Arzneimittelanwendungsforschung, Ausser der Schleifmühle 35-37, 28203, Bremen, Germany.
Z Gerontol Geriatr. 2006 Apr;39(2):143-8. doi: 10.1007/s00391-006-0337-y.
Benzodiazepines appear to increase the incidence of hip fractures. Their role as a time-dependent risk factor remains unclear. We therefore conducted a case-crossover study to determine whether the new use of benzodiazepines is associated with a rise in hip fractures. We analysed 49 months of the statutory health insurance Gmünder Ersatzkasse (GEK) and enrolled all first hip fractures. The index date was the day of hospital admission. Exposure to new use of benzodiazepines was compared within the five periods preceding the index date. Out of 1630 subjects, 223 (13.7%) had at least one prescription of benzodiazepines in the preceding 150 days before the index date, 74 (4.5%) of them as a first prescription. The average age of the population was 79.8 years (SD: 7.7). Odds ratio (OR) of hip fracture was highest during the initial 5 days of new use (OR: 3.43; 95% CI 1.15-10.20) and then declined to a non-significant OR of 1.59 (95% CI 0.96-2.63) after 30 days. In conclusion, the start of a new benzodiazepine is associated with an increased risk of hip fractures. However, the population attributable risk (PAR) and, therefore, the percentage of preventable events is small (PAR: 0.55%; 95% CI 0.05-1.06%).
苯二氮䓬类药物似乎会增加髋部骨折的发生率。其作为时间依赖性风险因素的作用仍不清楚。因此，我们进行了一项病例交叉研究，以确定新使用苯二氮䓬类药物是否与髋部骨折风险增加有关。我们分析了法定医疗保险贡德替代保险（GEK）49个月的数据，并纳入了所有首次髋部骨折病例。索引日期为入院当天。将索引日期前五个时间段内新使用苯二氮䓬类药物的暴露情况进行比较。在1630名受试者中，223人（13.7%）在索引日期前150天内至少有一次苯二氮䓬类药物处方，其中74人（4.5%）为首次处方。人群的平均年龄为79.8岁（标准差：7.7）。新使用苯二氮䓬类药物最初5天内髋部骨折的比值比（OR）最高（OR：3.43；95%置信区间1.15 - 10.20），30天后降至无统计学意义的OR为1.59（95%置信区间0.96 - 2.63）。总之，开始新使用苯二氮䓬类药物与髋部骨折风险增加有关。然而，人群归因风险（PAR）以及因此可预防事件的百分比很小（PAR：0.55%；95%置信区间0.05 - 1.06%）。
