Benzodiazepine-related traffic accidents in young and elderly drivers
Benzodiazepine-related traffic accidents in young and elderly drivers
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DOI：
10.1002/(sici)1099-1077(1998110)13:2
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发表时间：
1998-11-01
影响因子：
1.7
通讯作者：
Neutel, I
中科院分区：
文献类型：
--
作者：
Neutel, I
实验和流行病学研究已经很好地建立了使用BZD与驾驶技能受损的关系。有人担心老年人可能比年轻人受到更大的影响，但经验证据不太清楚。本研究将检查老年人（60岁以上）与年轻人使用BZD后伤害性交通事故风险的差异。此外，还将考虑短效和长效BZD的效果差异，以及更初步的首次和长期效果差异。研究设计是一项流行病学队列研究，数据来自萨斯喀彻温省卫生数据库。研究人群包括225796名20岁以上首次使用BZD处方的患者和97862名对照患者。所有首次使用者如果在任何5个月内接受3次处方，则有资格进入重复使用者队列。新使用者在BZD处方的前4周内发生伤害性交通事故的风险增加，OR = 3.1（1.5-6.2）。60岁以下的人有OR = 3.2（1.3-8.1）的风险，而老年人的OR = 2.8（1.0-8.4）。对于个体BZD，泮的风险增加幅度最大，OR = 5.1;按年龄分层，60岁以下年龄组的OR为6.1，60岁以上年龄组的OR为3.4。重复使用人群中的交通事故数量非常少，但它们暗示重复使用者的风险可能低于新使用者。这些结果需要得到证实，建议进行进一步的研究，以查明年龄，BZD类型和使用时间的各种潜在影响之间的关系。(C)1998约翰威利父子有限公司
The relation of BZD use to impaired driving skills has been well established by both experimental and epidemiologic studies. There has been a concern that elderly people might be more affected than younger people, but for this the empirical evidence is less clear. The present study will examine the differences in risk of injurious traffic accidents after BZD use in older adults (60+) compared with those younger. Also the differences in effect of short acting and long acting BZD and, more tentatively, differences in effect of first-time and long term will be considered. The study design is an epidemiologic cohort study for which data was received from the Saskatchewan Health Data Bases. The study population consists of 225 796 persons above 20 with a first BZD prescription, and 97 862 controls. All first-time users were eligible for entering the repeat users cohort if they received three prescriptions within any 5 month period. New users increased their risk of injurious traffic accidents within the first 4 weeks of the BZD prescription at an OR = 3.1 (1.5-6.2). Persons under 60 had a risk of OR = 3.2 (1.3-8.1), while older people had OR = 2.8 (1.0-8.4). For individual BZD, flurazepam showed the largest increase in risk at OR = 5.1; stratified for age the OR was 6.1 for the under 60 and 3.4 for the over 60 age groups. The number of traffic accidents in the repeat use population was very small, but they hint at the possibility that repeat users have a lower risk than new users. These results need to be confirmed and the recommendations are that further studies be done to ferret out relations among the various potential influences of age, type of BZD and length of use. (C) 1998 John Wiley & Sons, Ltd.