Ray W A, Griffin M R, Downey W
Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2637.
JAMA. 1989 Dec 15;262(23):3303-7.
To determine if the risk of hip fracture difference between persons receiving benzodiazepines with long (greater than or equal to 24 hours) or short (less than 24 hours) elimination half-lives, we conducted a nested case-control study among residents of the Canadian province of Saskatchewan who were 65 years of age and older. We identified 4501 cases occurring between 1977 and 1985 from computerized hospital records and 24,041 population controls. Current benzodiazepine use, defined as having filled a prescription in the past 30 days, was ascertained from computerized pharmacy records. The relative risk of hip fracture was 1.7 (95% confidence interval, 1.5 to 2.0) for current users of long half-life benzodiazepines, in contrast to that of 1.1 (95% confidence interval, 0.9 to 1.3) for current users of short half-life drugs. This finding was not altered by sex, age, calendar year, nursing home residence, or history of hospitalization. Medical record review for a sample of 189 cases suggested that this finding was not due to confounding by dementia, ambulatory status, functional status, or body mass.
为了确定服用消除半衰期长（大于或等于24小时）或短（小于24小时）的苯二氮䓬类药物的人群之间髋部骨折风险的差异，我们在加拿大萨斯喀彻温省65岁及以上的居民中进行了一项巢式病例对照研究。我们从计算机化的医院记录中识别出1977年至1985年间发生的4501例病例，并选取了24,041名人群作为对照。当前苯二氮䓬类药物的使用定义为在过去30天内开具过处方，这是通过计算机化药房记录确定的。长半衰期苯二氮䓬类药物的当前使用者髋部骨折的相对风险为1.7（95%置信区间为1.5至2.0），相比之下，短半衰期药物的当前使用者的相对风险为1.1（95%置信区间为0.9至1.3）。这一发现不受性别、年龄、历年、养老院居住情况或住院史的影响。对189例病例样本的病历审查表明，这一发现并非由痴呆、活动状态、功能状态或体重的混杂因素导致。
