Predictors of falls and fractures leading to hospitalization in people with schizophrenia spectrum disorder: A large representative cohort study
Predictors of falls and fractures leading to hospitalization in people with schizophrenia spectrum disorder: A large representative cohort study
复制标题
DOI：
10.1016/j.schres.2018.05.010
复制
发表时间：
2018-11-01
影响因子：
4.5
通讯作者：
Perera, Gayan
中科院分区：
文献类型：
--
作者：
Stubbs, Brendon;Mueller, Christoph;Perera, Gayan
目的：为了探讨精神分裂症谱系障碍（ICD F20-29）患者住院治疗的福尔斯/骨折的预测因素，使用南伦敦和Maudsley NHS生物医学研究中心病例登记册的数据，收集了01/2006-12/2012精神分裂症谱系障碍（ICD F20-29）患者的历史队列。通过与国家住院数据的联系确定了福尔斯/骨折。采用单独的多变量考克斯回归分析来确定福尔斯和骨折的预测因素。结果：在11,567名精神分裂症患者中（平均年龄42.6岁，43%为女性），579（发病率12.79/1000人-年）和528（11.65/1000人年）分别至少报告了一次因跌倒或骨折住院，822例患者在此期间至少记录了跌倒或骨折（即样品的7.1%）。总的来说，每1000人年随访的住院时间分别为6.69年和10.74年。因跌倒和骨折死亡分别为14例（0.12%）和28例（0.24%）。多因素分析显示，年龄增加、白色种族、止痛药、心血管疾病、高血压、泌尿生殖系统疾病、视力障碍和晕厥是福尔斯和骨折的显著危险因素。既往骨折（HR 2.05，95%CI 1.53-2.73）和骨质疏松（HR 6.79，95%CI 4.71-9.78）是继发骨折的强危险因素。骨质疏松症和既往骨折是后续骨折的强有力预测因素。需要在这些人群中开发和评估针对骨健康和福尔斯/骨折的干预措施。(C)2018作者由爱思唯尔公司出版
Aim: To investigate predictors of falls/fractures leading to hospitalisation in people with schizophrenia-spectrum disorders.Methods: A historical cohort of people with schizophrenia-spectrumdisorders (ICD F20-29) from 01/2006-12/2012 was assembled using data from the South London and Maudsley NHS Biomedical Research Centre Case Register. Falls/fractures were ascertained from a linkage to national hospitalisation data. Separate multivariate Cox regression analyses were employed to identify predictors of falls and fractures.Results: Of 11,567 people with schizophrenia-spectrum disorders (mean age 42.6 years, 43% female), 579 (incidence rate 12.79 per 1000 person-years) and 528 (11.65 per 1000 person-years) had at least one reported hospital admission due to a fall or fracture respectively and 822 patients had at least either a recorded fall or a fracture during this period (i.e. 7.1% of sample). Overall, 6.69 and 10.74 years of inpatient hospital stay per 1000-person years of follow-up occurred due to a fall and fracture respectively. 14(0.12%) and 28(0.24%) died due to a fall and fracture respectively. In Multivariable analysis, increasing age, white ethnicity, analgesics, cardiovascular disease, hypertension, diseases of the genitourinary system, visual disturbance and syncope were significant risk factor for both falls and fractures. A previous fracture (HR 2.05, 95% CI 1.53-2.73) and osteoporosis (HR 6.79, 95% CI 4.71-9.78) were strong risk factors for consequent fractures.Conclusion: Comorbid physical health conditions and analgesic medication prescription were associated with higher risk of falls and fractures. Osteoporosis and previous fracture were strong predictors for subsequent fractures. Interventions targeting bone health and falls/fractures need to be developed and evaluated in these populations. (C) 2018 The Authors. Published by Elsevier B.V.