Department of Clinical Sciences in Malmö, Social Medicine and Health Politics, Faculty of Medicine, Lund University, and CRC, Scania University Hospital, Malmö, Sweden.
Eur J Public Health. 2012 Oct;22(5):726-32. doi: 10.1093/eurpub/ckr110. Epub 2011 Sep 6.
Injuries are second to cardiovascular diseases, the main cause of hospital care in Sweden. The aim of the present study was to investigate the associations between medication with psychotropic drugs and injuries from two types of accidents, i.e. falling accidents and transportation accidents, respectively, in the whole population aged≥18 years in the county of Scania, Sweden.
Injuries from falling accidents and transportation accidents during 2007 were identified from the Region Healthcare database. Exposure to psychotropic medication expressed as defined daily doses (DDDs) during the 18 months before baseline, i.e. 1 January 2007, was identified from the Swedish Medication Register. The results were stratified by sex and three age groups, i.e. 18-34 years, 35-64 years and ≥65. The logistic regression models were adjusted for marital status, country of origin, income, previous disease and previous accidents.
Using psychotropic drugs was associated with increased odds for a falling accident in all age groups, however, with a dose-response relationship only among the elderly. Furthermore, using psychotropic drugs was associated with increased odds of transportation accidents in the ages 18-34 years and 35-64 years, respectively, but with a weaker association among the elderly. A similar pattern of association was seen for specific groups of psychotropic drugs: opioids, anti-depressants and anxiolytics/hypnotics/sedatives.
In this total population-based study, there were nearly consistent associations between use of psychotropic drugs and injuries from falling accidents and transportation accidents, even after adjustment for previous accidents, previous disease and socio-demographic variables.
在瑞典，伤害是仅次于心血管疾病的导致住院治疗的主要原因。本研究旨在调查精神药物的使用与两种类型的事故（即跌倒事故和交通意外事故）所致伤害之间的相关性，研究对象为瑞典斯科讷县所有年龄≥18 岁的人群。
2007 年发生的跌倒事故和交通意外事故的伤害情况从地区医疗保健数据库中识别。使用 18 个月（2007 年 1 月 1 日之前）前的精神药物暴露情况（定义为每日剂量 DDD）从瑞典药物登记处确定。结果按照性别和三个年龄组（18-34 岁、35-64 岁和≥65 岁）进行分层。逻辑回归模型调整了婚姻状况、原籍国、收入、既往疾病和既往事故等因素。
使用精神药物与所有年龄段的跌倒事故风险增加相关，然而仅在老年人中存在剂量反应关系。此外，使用精神药物与 18-34 岁和 35-64 岁年龄组的交通意外事故风险增加相关，但在老年人中相关性较弱。特定类别的精神药物（阿片类药物、抗抑郁药和抗焦虑药/催眠药/镇静剂）也呈现出类似的关联模式。
在这项基于全人群的研究中，即使在调整了既往事故、既往疾病和社会人口统计学变量后，精神药物的使用与跌倒事故和交通意外事故所致伤害之间仍存在几乎一致的相关性。
