Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level: a cohort study

BMC Geriatrics

Research Article

Karin Ranstad¹  Patrik Midlöv¹  Anders Halling²  Lars Borgquist³  Kristine Thorell⁴ 

[1] Department of Clinical Sciences in Malmö, General Practice/Family Medicine, Lund University, SE-205 02, Malmö, Sweden;Department of Clinical Sciences in Malmö, General Practice/Family Medicine, Lund University, SE-205 02, Malmö, Sweden;Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9a, DK-5000, Odense C, Denmark;Department of Medical and Health Sciences, General Practice, Linköping University, SE-581 83, Linköping, Sweden;Department of Patient Safety, Blekinge County Council, SE-371 85, Karlskrona, Sweden;Department of Clinical Sciences in Malmö, General Practice/Family Medicine, Lund University, SE-205 02, Malmö, Sweden;

关键词: Hip fracture;    Multimorbidity level;    Fall risk-increasing drugs;    Elderly;    Medication review;    Sweden;   

DOI  :  10.1186/1471-2318-14-131

 received in 2014-06-27, accepted in 2014-11-27,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundRisk factors for hip fracture are well studied because of the negative impact on patients and the community, with mortality in the first year being almost 30% in the elderly. Age, gender and fall risk-increasing drugs, identified by the National Board of Health and Welfare in Sweden, are well known risk factors for hip fracture, but how multimorbidity level affects the risk of hip fracture during use of fall risk-increasing drugs is to our knowledge not as well studied. This study explored the relationship between use of fall risk-increasing drugs in combination with multimorbidity level and risk of hip fracture in an elderly population.MethodsData were from Östergötland County, Sweden, and comprised the total population in the county aged 75 years and older during 2006. The odds ratio (OR) for hip fracture during use of fall risk-increasing drugs was calculated by multivariate logistic regression, adjusted for age, gender and individual multimorbidity level. Multimorbidity level was estimated with the Johns Hopkins ACG Case-Mix System and grouped into six Resource Utilization Bands (RUBs 0–5).Results2.07% of the study population (N = 38,407) had a hip fracture during 2007. Patients using opioids (OR 1.56, 95% CI 1.34-1.82), dopaminergic agents (OR 1.78, 95% CI 1.24-2.55), anxiolytics (OR 1.31, 95% CI 1.11-1.54), antidepressants (OR 1.66, 95% CI 1.42-1.95) or hypnotics/sedatives (OR 1.31, 95% CI 1.13-1.52) had increased ORs for hip fracture after adjustment for age, gender and multimorbidity level. Vasodilators used in cardiac diseases, antihypertensive agents, diuretics, beta-blocking agents, calcium channel blockers and renin-angiotensin system inhibitors were not associated with an increased OR for hip fracture after adjustment for age, gender and multimorbidity level.ConclusionsUse of fall risk-increasing drugs such as opioids, dopaminergic agents, anxiolytics, antidepressants and hypnotics/sedatives increases the risk of hip fracture after adjustment for age, gender and multimorbidity level. Fall risk-increasing drugs, high age, female gender and multimorbidity level, can be used to identify high-risk patients who could benefit from a medication review to reduce the risk of hip fracture.

【 授权许可】

CC BY   
© Thorell et al.; licensee BioMed Central Ltd. 2014