Antipsychotic Treatment and the Risk of Hip Fracture in Subjects With Schizophrenia: A 10-Year Population-Based Case-Control Study

Primary care companion to the journal of clinical psychiatry

Hui-Ju Tsai¹  Yu-Ting Tsai¹  Chi-Shin Wu¹  Chia-Ming Chang¹  Ya-Wen Huang¹ 

关键词: Saccharides;    Yogurts;    Determination by classes;    HPLC;    Refractive index detector.;   

DOI  :  10.4088/JCP.14m09098

学科分类：精神健康和精神病学

来源: Physicians Postgraduate Press,Inc.

【 摘 要 】

Background: To investigate the association between antipsychotic treatment and risk of hip fracture in subjects with schizophrenia.Method: Among patients with schizophrenia (ICD-9-CM code 295), 605 cases with hip fracture and 2,828 matched controls were identified from 2002 to 2011 using the National Health Insurance Research Database in Taiwan. The authors conducted a nested case-control study to investigate the association between antipsychotic treatment and risk of hip fracture in subjects with schizophrenia. The modifiable effects of age and gender were evaluated by stratified analysis. In addition, the effects of antipsychotic use, antipsychotic classes, and receptor-binding profiles of antipsychotics, individually, on hip fracture were estimated, and potential confounding factors were adjusted in subsequent analysis. Conditional logistic regressions were applied to determine the effect of antipsychotic treatment on hip fracture.Results: Current antipsychotic use was associated with an increased risk for hip fracture (adjusted odds ratio [AOR] = 1.61; 95% CI, 1.24�?2.10). Among current users, new users had a higher risk of hip fracture (AOR = 4.28; 95% CI, 1.76�?10.36) than past users (AOR = 1.11; 95% CI, 0.79�?1.56). In addition, a significant increased risk of hip fracture was noted in schizophrenia subjects with first-generation antipsychotic use (AOR = 1.59; 95%CI, 1.15�?2.20) but not in those with second-generation antipsychotic use (AOR = 1.16; 95% CI, 0.91�?1.48).Conclusions: These results extend previous findings and demonstrate an increased risk of hip fracture associated with antipsychotic use in schizophrenia subjects. Further investigation is needed to dissect the underlying mechanisms related to the effect of antipsychotic use on hip fracture in subjects at risk.

【 授权许可】

Unknown