Association of benzodiazepine and Z-drug use with the risk of hospitalisation for fall-related injuries among older people: a nationwide nested case–control study in Taiwan

BMC Geriatrics

Research Article

Hui-Ju Tsai¹  Pei-Jung Chen²  Yu-Wen Chiu³  Chih-Wan Huang³  Chia-Ming Chang³  Nan-Wen Yu³  Wen-Ing Tsay⁴  Jui Hsu⁴ 

[1] Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA;Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan;Department of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan;Department of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan;Division of Rehabilitation & Community Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan;Division of Controlled Drugs, Taiwan Food and Drug Administration (TFDA), Ministry of Health and Welfare, Executive Yuan, Taipei, Taiwan;

关键词: Benzodiazepine;    Z-drugs;    Older people;    Fall;    Hospitalisation;   

DOI  :  10.1186/s12877-017-0530-4

 received in 2016-10-12, accepted in 2017-07-04,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundNon-benzodiazepine hypnotics (Z-drugs) are advocated to be safer than benzodiazepines (BZDs). This study comprehensively investigated the association of BZD and Z-drug usage with the risk of hospitalisation for fall-related injuries in older people.MethodsThis study used the Taiwan National Health Insurance Database with a nested matched case-control design. We identified 2238 elderly patients who had been hospitalised for fall-related injuries between 2003 and 2012. They were individually matched (1:4) with a comparison group by age, sex, and index year. Conditional logistic regression was used to determine independent effects of drug characteristics (type of exposure, dosage, half-life, and polypharmacy) on older people.ResultsOlder people hospitalisation for fall-related injuries were significantly associated with current use of BZDs (adjusted odds ratio [AOR] = 1.32, 95% confidential interval [CI] = 1.17–1.50) and Z-drugs (AOR = 1.24, 95%CI = 1.05–1.48). At all dose levels of BZDs, high dose levels of Z-drugs, long-acting BZD, and short-acting BZD use were all significantly increased the risk of fall-related injuries requiring hospitalisation. Polypharmacy, the use of two or more kinds of BZDs, one kind of BZD plus Z-drugs and two or more kinds of BZDs plus Z-drugs, also significantly increased the risk (AOR = 1.61, 95% CI = 1.38–1.89; AOR = 1.65, 95% CI = 1.08–2.50, and AOR = 1.58, 95% CI = 1.21–2.07).ConclusionsDifferent dose levels and half-lives of BZDs, a high dose of Z-drugs, and polypharmacy with BZDs and Z-drugs were associated with an increased risk of fall-related injury requiring hospitalisation in older people. Physicians should balance the risks and benefits when prescribing these drug regimens to older people considering the risk of falls.

【 授权许可】

CC BY   
© The Author(s). 2017