与匹配对照组相比，心境障碍患者脊柱骨折风险增加的评估：一项使用韩国全国样本队列的纵向随访研究。

Evaluation of the increased risk of spine fracture in patients with mood disorder compared with matched controls: a longitudinal follow-up study using a national sample cohort in Korea.

作者信息

Kim So Young, Min Chanyang, Park Bumjung, Kim Miyoung, Choi Hyo Geun

机构信息

Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.

Hallym Data Science Laboratory, Hallym University College of Medicine, Chuncheon, South Korea.

出版信息

BMJ Open. 2019 Nov 28;9(11):e027581. doi: 10.1136/bmjopen-2018-027581.

DOI:10.1136/bmjopen-2018-027581

PMID:31784429

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6924799/

Abstract

OBJECTIVE

To evaluate the risk of spine fracture in patients with mood disorder using a nationwide cohort.

DESIGN

A longitudinal follow-up study.

SETTING

Claims data for the population ≥20 years of age were collected from 2002 to 2013 for the Korean National Health Insurance Service-National Sample Cohort.

PARTICIPANTS

A total of 60 140 individuals with mood disorder were matched with 240 560 individuals (control group) for age, sex, income, region of residence and osteoporosis.

INTERVENTIONS

In both the mood disorder and control groups, the history of spine fracture was evaluated. The International Classification of Diseases 10th Revision codes for mood disorder (F31-F39) and spine fracture (S220 and S320) were included.

PRIMARY AND SECONDARY OUTCOME MEASURES

The univariable and multivariable HRs and 95% CIs of spine fracture for patients with mood disorder were analysed using a stratified Cox proportional hazards model. Subgroup analyses were conducted according to the history of osteoporosis, age and sex.

RESULTS

Approximately 3.3% (2011/60 140) of patients in the mood disorder group and 2.8% (6795/240 560) of individuals in the control group had spine fracture (p<0.001). The mood disorder group demonstrated a higher adjusted HR for spine fracture than the control group (multivariable HR=1.10, 95% CI 1.04 to 1.15, p<0.001). The participants without osteoporosis showed a higher HR of mood disorder for spine fracture than the control participants (multivariable HR=1.25, 95% CI 1.14 to 1.37, p<0.001). According to age and sex, this result was consistent in subgroups of women aged 20-39 and 40-59 years and men aged ≥60 years.

CONCLUSION

The risk of spine fracture was increased in patients with mood disorder. The potential risk of spine fracture needs to be evaluated when managing patients with mood disorder.

摘要

目的

利用全国性队列评估情绪障碍患者发生脊柱骨折的风险。

设计

一项纵向随访研究。

设置

从2002年至2013年收集韩国国民健康保险服务全国样本队列中年龄≥20岁人群的索赔数据。

参与者

总共60140名情绪障碍患者与240560名个体（对照组）在年龄、性别、收入、居住地区和骨质疏松症方面进行匹配。

干预措施

在情绪障碍组和对照组中，均评估脊柱骨折病史。纳入了国际疾病分类第10版中情绪障碍（F31 - F39）和脊柱骨折（S220和S320）的编码。

主要和次要结局指标

使用分层Cox比例风险模型分析情绪障碍患者脊柱骨折的单变量和多变量风险比（HR）及95%置信区间（CI）。根据骨质疏松症病史、年龄和性别进行亚组分析。

结果

情绪障碍组中约3.3%（2011/60140）的患者和对照组中2.8%（6795/240560）的个体发生了脊柱骨折（p<0.001）。情绪障碍组脊柱骨折的调整后HR高于对照组（多变量HR = 1.10，95%CI 1.04至1.15，p<0.001）。无骨质疏松症的参与者发生脊柱骨折的情绪障碍HR高于对照参与者（多变量HR = 1.25，95%CI 1.14至1.37，p<0.001）。根据年龄和性别，在20 - 39岁和40 - 59岁的女性亚组以及≥60岁的男性亚组中，这一结果是一致的。