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[使用抗精神病药物治疗的患者髋部骨折。加泰罗尼亚回顾性队列研究]

[Hip fractures in patients treated with antipsychotic drugs. Study of retrospective cohorts in Catalonia].

作者信息

González Tejón Susana, Ibarra Jato Montserrat, Fernández San Martín M Isabel, Prats Uribe Albert, Real Gatius Jordi, Martin-Lopez Luis Miguel

机构信息

Equipo Atención Primaria Raval Sud, Barcelona, España; Grup TMS IdiapJgol, Barcelona, España.

Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar Hospital del Mar, Barcelona, España.

出版信息

Aten Primaria. 2022 Feb;54(2):102171. doi: 10.1016/j.aprim.2021.102171. Epub 2021 Nov 16.

Abstract

OBJECTIVE

To evaluate the incidence of hip fracture in patients with antipsychotic treatment, comparing it with that of individuals who have not been treated with antipsychotics.

DESIGN

Retrospective cohort study of patients treated with antipsychotic drugs (TAP) and patients without known treatment (non-TAP). The observation period was 2006-2014. SITE: All primary care teams in Catalonia of the Catalan Health Institute (ICS).

PARTICIPANTS

Patients older than 44 years with TAP lasting at least 3 months. Control cohort: random selection of non-TAP patients matching for baseline comorbidities and other variables. A total of 22,010 are analyzed. Main measurements Incidence rate (1000× person-years: PY) of hip fracture in each group (TAP and non-TAP). Cox regression models to estimate adjusted risks (hazard ratio: HR).

RESULTS

The hip fracture incidence rate was higher in TAP patients (5.83 vs 3.58 fractures per 1000 PY), and is higher in all strata according to sex, age and type of diagnosis. The risk of suffering a hip fracture was 60% higher (HR: 1.60 95% CI: 1.34-1.92) in the TAP group than in the non-TAP group. The risk was higher in the group with schizophrenia (HR: 3.57 95% CI: 1.75-7.30), followed by bipolar disorder (HR: 2.61; 95% CI: 1.39-4.92) and depression (HR: 1.51; 95% CI: 1.21-1.88).

CONCLUSIONS

Patients with antipsychotic treatment have a higher risk of hip fracture than those who have not been treated with antipsychotics.

摘要

目的

评估接受抗精神病药物治疗的患者髋部骨折的发生率,并与未接受抗精神病药物治疗的个体进行比较。

设计

对抗精神病药物治疗患者(TAP)和未接受已知治疗的患者(非TAP)进行回顾性队列研究。观察期为2006年至2014年。地点:加泰罗尼亚卫生研究所(ICS)在加泰罗尼亚的所有初级保健团队。

参与者

年龄大于44岁且接受抗精神病药物治疗至少3个月的患者。对照组:随机选择与基线合并症和其他变量相匹配的非TAP患者。共分析了22,010例。主要测量指标为每组(TAP和非TAP)髋部骨折的发病率(每1000人年:PY)。采用Cox回归模型估计调整后的风险(风险比:HR)。

结果

TAP患者的髋部骨折发病率较高(每1000 PY为5.83例骨折对3.58例骨折),并且在按性别、年龄和诊断类型划分的所有分层中均较高。TAP组发生髋部骨折的风险比非TAP组高60%(HR:1.60,95% CI:1.34 - 1.92)。精神分裂症组的风险更高(HR:3.57,95% CI:1.75 - 7.30),其次是双相情感障碍(HR:2.61;95% CI:1.39 - 4.92)和抑郁症(HR:1.51;95% CI:1.21 - 1.88)。

结论

接受抗精神病药物治疗的患者发生髋部骨折的风险高于未接受抗精神病药物治疗的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e3d/8605286/7d99a08f34c2/gr1.jpg

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