Tsai Chun-Hao, Cheng Wan-Ju, Muo Chih-Hsin, Lin Tsung-Li
Department of Orthopedics, China Medical University Hospital.
School of Medicine, China Medical University.
Medicine (Baltimore). 2019 Jan;98(3):e14148. doi: 10.1097/MD.0000000000014148.
This study aimed to evaluate the association between fracture history and sequential risk of suicidal behavior.A total of 82,804 patients with fractures and 82,804 control subjects without fractures were matched. The influence of fractures on the risk of suicidal behavior-related hospital visit was analyzed using a Cox proportional hazards model.The overall adjusted hazard ratio (aHR) of suicidal behavior-related hospital visit was 2.21 in fracture cohort. The aHR declined from 2.90 at the 1-year follow-up to 2.00 after 5 years or more. In fracture patients, the risk of suicidal behavior-related hospital visit was higher at age <35 years, with comorbidities of stroke and sleep disorder. Patients with multiple fractures had a 1.69-fold risk.Fractures are an independent risk factor for suicidal behavior. Individuals aged younger than 35 years, with comorbidities of stroke and sleep disorder, and those who have suffered multiple fractures have elevated risk of suicidal behavior among subjects in the fracture group. Furthermore, this increased risk remained even after 5 years had passed since the fracture incident.
本研究旨在评估骨折病史与自杀行为后续风险之间的关联。共匹配了82804例骨折患者和82804例无骨折的对照对象。使用Cox比例风险模型分析骨折对自杀行为相关就诊风险的影响。骨折队列中自杀行为相关就诊的总体调整风险比（aHR）为2.21。aHR从1年随访时的2.90降至5年或更长时间后的2.00。在骨折患者中，年龄<35岁、患有中风和睡眠障碍合并症的患者，自杀行为相关就诊风险更高。多处骨折的患者风险为1.69倍。骨折是自杀行为的独立危险因素。在骨折组中，年龄小于35岁、患有中风和睡眠障碍合并症的个体以及多处骨折的个体自杀行为风险升高。此外，即使在骨折事件发生5年后，这种增加的风险仍然存在。
