PSYCHOTROPICS, THIAZIDE DIURETICS AND HIP-FRACTURES IN THE ELDERLY
PSYCHOTROPICS, THIAZIDE DIURETICS AND HIP-FRACTURES IN THE ELDERLY
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DOI：
10.5694/j.1326-5377.1993.tb121839.x
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发表时间：
1993-03-15
影响因子：
11.4
通讯作者：
KLINEBERG, RJ
中科院分区：
文献类型：
--
作者：
CUMMING, RG;KLINEBERG, RJ
目的：为了确定是否精神药物增加，噻嗪类利尿剂减少，髋部骨折的风险在老年人Australians.Design：人口为基础的病例对照study.Subjects和设置：人口年龄在65岁及以上的生活在一个确定的地区在悉尼西部，澳大利亚，在1990-1991年。病例组（n=209）从医院招募，对照组（n=207）通过区域概率抽样方法选择，并从疗养院额外抽样。应答率为96%的情况下，84%controls.Measures：数据直接从受试者通过问卷调查收集，代理受访者需要为27%的受试者。除了药物使用，还收集了潜在混杂因素的信息：饮酒，体重指数，认知状态，乳制品消费，健康状况，体力活动，吸烟史和居住类型。结果：使用替马西泮，一种短效苯二氮卓类药物，与髋部骨折风险增加相关-比值比，经年龄，性别和居住地调整后为3.78; 95%置信区间（CI）为1.60-8.92。通过logistic回归校正多个潜在混杂因素后，替马西泮使用的优势比为3.52。使用抗抑郁药和抗精神病药与髋部骨折风险无显著性（P>0.05）增加。噻嗪类利尿剂与髋部骨折的风险无关-多变量调整的比值比为0.98（95%CI，0.49-1.99）。结论：替马西泮可能增加老年人髋部骨折的风险。噻嗪类利尿剂对骨折风险的影响应在一项大型随机试验中进行评估。
Objective: To determine whether psychotropic medications increase, and thiazide diuretics decrease, the risk of hip fractures in elderly Australians.Design: Population-based case-control study.Subjects and Setting: The population aged 65 years and over living in a defined area in western Sydney, Australia, during 1990-1991. Cases (n=209) were recruited from hospitals and controls (n=207) were selected by an area probability sampling method, with additional sampling from nursing homes. Response rates were 96% for cases and 84% for controls.Measures: Data were collected directly from subjects by questionnaire; a proxy respondent was required for 27% of subjects. In addition to medication use, information was also collected on potential confounders: alcohol consumption, body mass index, cognitive status, dairy product consumption, health status, physical activity, smoking history and type of residence.Results: The use of temazepam, a short-acting benzodiazepine, was associated with an increase in the risk of hip fracture - odds ratio, adjusted for age, gender and residence is 3.78; 95% confidence interval (CI), 1.60-8.92. After adjusting for multiple potential confounders by logistic regression, the odds ratio for temazepam use was 3.52. There was a non-significant (P>0.05) increase in hip fracture risk associated with the use of antidepressants and antipsychotics. Thiazide diuretics were not associated with a risk of hip fracture - the multivariate-adjusted odds ratio was 0.98 (95% CI, 0.49-1.99).Conclusions: Temazepam may increase the risk of hip fracture in elderly people. The effect of thiazide diuretics on fracture risk should be assessed in a large randomised trial.