Hip, vertebral, and wrist fracture risks and schizophrenia: a nationwide longitudinal study

BMC Psychiatry

Shyh-Chyang Lee¹  Yu-Wen Chu²  Yao-Tung Lee³  Li-Yu Hu⁴  Wen-Pin Chen⁵  Cheng-Che Shen⁶  Shih-Jen Tsai⁷  Albert C. Yang⁸ 

[1] Department of Orthopedics, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan;Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan;Faculty of Pharmacy, School of Pharmaceutical Sciences, National Yang-Ming University, Taipei, Taiwan;Center for General Education, Tunghai University, Taichung, Taiwan;Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, No.291, Zhongzheng Rd., Zhonghe District, 23561, New Taipei City, Taiwan;Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Center of dementia, Shuang Ho Hospital, Taipei Medical University, New Taipei city, Taiwan;Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan;Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan;Department of Radiology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan;Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan;Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, No. 600, Sec. 2, Shixian Rd., West District, Chiayi City, Taiwan;Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Chiayi City, Taiwan;Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan;Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan;Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan;Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan;Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA;

关键词: Schizophrenia;    Fracture;    Hazard ratio;    National Health Insurance Research Database;    Cohort study;   

DOI  :  10.1186/s12888-022-03723-7

来源: Springer

【 摘 要 】

BackgroundFractures are a great health issue associated with morbidity, quality of life, life span, and health care expenditure. Fractures are correlated with cardiovascular disease, type 2 diabetes mellitus, cerebrovascular disease, and some psychiatric disorders. However, representative national data are few, and longitudinal cohort studies on the association between schizophrenia and the subsequent fracture risk are scant. We designed a nationwide population-based cohort study to investigate the association of schizophrenia with hip, vertebral, and wrist fractures over a 10-year follow-up.MethodsData of patients with schizophrenia (International Classification of Diseases, Ninth Revision, Clinical Modification code 295) and matched over January 2000–December 2009) were extracted from Taiwan National Health Insurance Research Database. A Cox proportional-hazards regression model was constructed to calculate hazard ratios (HRs) for fractures between the schizophrenia and control cohorts.ResultsOf 2028 people with schizophrenia (mean age: 36.3 years, 49.4% female), 89 (4.4%) reported newly diagnosed fractures—significantly higher than the proportion in the control population (257, 3.2%; P = 0.007). The incidences of hip (1.2%, P = 0.009) and vertebral (2.6%, P = 0.011) fractures were significantly higher in the schizophrenia cohort than in the control cohort. In Cox regression analysis, hip (adjusted HR: 1.78, 95% confidence interval [CI]: 1.08–2.93) and vertebral (adjusted HR: 1.40, 95% CI: 1.01–1.95) fracture risks were significantly higher in patients with schizophrenia. Furthermore, a sex-based subgroup analysis revealed that the risk of hip fracture remained significantly higher in female patients with schizophrenia (HR: 2.68, 95% CI: 1.32–5.44) than in female controls. On the other hand, there was no significant interaction between effects of sex and schizophrenia on the risk of fractures.ConclusionsOver a 10-year follow-up, hip and vertebral fracture risks were higher in the people with schizophrenia than in the controls. The risk of fractures in patients with schizophrenia does not differ between female and male.

【 授权许可】

CC BY