Zusammenfassung
Benzodiazepine scheinen mit einer erhöhten Inzidenz proximaler Femurfrakturen assoziiert zu sein. Ihre Rolle als zeitabhängiger Risikofaktor bleibt unklar. Diese Case-crossover-Studie wurde durchgeführt, um zu prüfen, ob der Neugebrauch von Benzodiazepinen mit einer Steigerung des Risikos proximaler Femurfrakturen assoziiert ist. Hierzu wurden die Routinedaten der Gmünder Ersatzkasse (GEK) genutzt und in einem Studienzeitraum von 49 Monaten alle Erstereignisse erfasst. Als Indexdatum wurde der Tag der stationären Aufnahme gewählt. Die Exposition zum Neugebrauch von Benzodiazepinen wurde in fünf Perioden vor dem Ereignis verglichen. Von insgesamt 1630 Personen erhielten 223 (13,7%) mindestens eine Benzodiazepinverordnung in den letzten 150 Tagen vor Indexdatum, davon 74 (4,5%) als Erstverordnung. Das Durchschnittsalter des Kollektivs lag bei 79,8 Jahren (SD: 7,7). Das Odds Ratio (OR) einer proximalen Femurfraktur war in den ersten 5 Tagen eines neuen Gebrauchs am höchsten (OR: 3,43; 95% KI 1,15–10,20) und fiel nach 30 Tagen auf nicht signifikante 1,59 (95% KI 0,96–2,63). Zusammenfassend bleibt festzuhalten, dass eine beginnende Benzodiazepintherapie mit einem erhöhten Risiko proximaler Femurfrakturen assoziiert ist. Mit einem populationsattributablen Risiko (PAR) von 0,55% (95% KI 0,05–1,06%) ist der Anteil darauf zurückzuführender Ereignisse allerdings gering.
Summary
Benzodiazepines appear to increase the incidence of hip fractures. Their role as a time-dependent risk factor remains unclear. We therefore conducted a case-crossover study to determine whether the new use of benzodiazepines is associated with a rise in hip fractures. We analysed 49 months of the statutory health insurance Gmünder Ersatzkasse (GEK) and enrolled all first hip fractures. The index date was the day of hospital admission. Exposure to new use of benzodiazepines was compared within the five periods preceding the index date. Out of 1630 subjects, 223 (13.7%) had at least one prescription of benzodiazepines in the preceding 150 days before the index date, 74 (4.5%) of them as a first prescription. The average age of the population was 79.8 years (SD: 7.7). Odds ratio (OR) of hip fracture was highest during the initial 5 days of new use (OR: 3.43; 95% CI 1.15–10.20) and then declined to a non-significant OR of 1.59 (95% CI 0.96–2.63) after 30 days. In conclusion, the start of a new benzodiazepine is associated with an increased risk of hip fractures. However, the population attributable risk (PAR) and, therefore, the percentage of preventable events is small (PAR: 0.55%; 95% CI 0.05–1.06%).
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Hoffmann, F., Glaeske, G. Neugebrauch von Benzodiazepinen und das Risiko einer proximalen Femurfraktur. Z Gerontol Geriatr 39, 143–148 (2006). https://doi.org/10.1007/s00391-006-0337-y
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DOI: https://doi.org/10.1007/s00391-006-0337-y