College of Medicine, China Medical University, Taichung, Taiwan.
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
Geriatr Gerontol Int. 2017 Dec;17(12):2552-2558. doi: 10.1111/ggi.13087. Epub 2017 Jul 14.
Little is known about the acute effects of furosemide use on the risk of hip fracture. The aim of the present study was to evaluate the association between furosemide use and acute risk of hip fracture in older people in Taiwan.
We carried out a retrospective nationwide case-control study using the database of the Taiwan National Health Insurance Program. A total of 4523 older adults aged ≥65 years with newly diagnosed hip fracture from 2000 to 2013 were identified as the cases. Additionally, 4523 older adults aged ≥65 years without hip fracture were randomly selected as the controls. The cases and the controls were matched by sex, age, comorbidities, and index year and month of hip fracture diagnosis. Furosemide use was defined as "current," "recent" or "past" if the furosemide prescription was filled <3 months, 3-6 months or ≥6 months before the date of hip fracture diagnosis, respectively. The unconditional logistic regression model was used to calculate the odds ratio and 95% confidence interval (CI) for the relative risk of hip fracture associated with furosemide use.
After adjustment for potential covariables, the adjusted odds ratios of hip fracture were 1.30 for participants with current use of furosemide (95% CI 1.14-1.48), 1.23 for participants with recent use of furosemide (95% CI 0.98-1.53) and 1.08 for participants with past use of furosemide (95% CI 0.90-1.30), compared with non-users.
Current use of furosemide is associated with a 30% increased odds of hip fracture in older people in Taiwan. Geriatr Gerontol Int 2017; 17: 2552-2558.
关于呋塞米使用对髋部骨折风险的急性影响知之甚少。本研究旨在评估在台湾老年人中，呋塞米的使用与髋部骨折的急性风险之间的关系。
我们使用台湾全民健康保险计划的数据库进行了一项回顾性全国病例对照研究。共纳入 2000 年至 2013 年间诊断为新发髋部骨折的 4523 名年龄≥65 岁的老年人作为病例。另外，还随机选择了 4523 名年龄≥65 岁且无髋部骨折的老年人作为对照。通过性别、年龄、合并症以及髋部骨折诊断的索引年月对病例和对照进行匹配。如果呋塞米处方在髋部骨折诊断日期前 3 个月、3-6 个月或≥6 个月内被开具，则定义为呋塞米使用为“当前”、“近期”或“过去”。使用无条件逻辑回归模型计算与呋塞米使用相关的髋部骨折相对风险的比值比和 95%置信区间（CI）。
在调整潜在协变量后，当前使用呋塞米的患者髋部骨折的调整比值比为 1.30（95%CI 1.14-1.48），近期使用呋塞米的患者为 1.23（95%CI 0.98-1.53），过去使用呋塞米的患者为 1.08（95%CI 0.90-1.30），与未使用者相比。
当前使用呋塞米与台湾老年人髋部骨折的风险增加 30%相关。老年医学与老年病学杂志 2017；17：2552-2558。
