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Nested Case Control Study on the Risk of Suicide Death in Elderly Patients with Pelvic Fractures Using a Nationwide Cohort

Authors
 Suk-Yong Jang  ;  Yonghan Cha  ;  Kap-Jung Kim  ;  Ha-Yong Kim  ;  Won-Sik Choy  ;  Kyung-Hoi Koo 
Citation
 CLINICS IN ORTHOPEDIC SURGERY, Vol.14(3) : 344-351, 2022-09 
Journal Title
CLINICS IN ORTHOPEDIC SURGERY
ISSN
 2005-291X 
Issue Date
2022-09
MeSH
Aged ; Aged, 80 and over ; Case-Control Studies ; Cohort Studies ; Fractures, Bone* / epidemiology ; Humans ; Pelvic Bones* ; Suicide* / psychology
Keywords
Elderly ; Pelvic fracture ; Suicide death
Abstract
Background: The aim of this study was to investigate the incidence rate of suicide deaths in elderly patients with pelvic fractures using a nationwide database and to analyze change in the risk of suicide death overtime after pelvic fractures compared to controls.

Methods: We used the National Health Insurance Service-Senior cohort (NHIS-Senior) of South Korea. Cases and controls were matched for sex, age, history of hospital admission within 1 year, and presence of depression on the date of suicide death. Controls were collected by random selection at a 1 : 5 ratio from patients at risk of becoming cases when suicide cases were collected. Incident pelvic fractures were identified from the NHIS-Senior as follows: first admission during the observational period (2002-2015) to an acute care hospital with a diagnostic code of International Statistical Classification of Diseases and Related Health Problems, 10th revision S321, S322, S323, S324, S325, or S328 and age 65-99 years. Conditional logistic regression analysis was performed to evaluate the association between pelvic fractures and the risk of suicide death.

Results: A total of 2,863 suicide cases and 14,315 controls were identified. Suicide case patients had been more frequently exposed to steroids (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.21-1.45), benzodiazepines (OR, 1.76; 95% CI, 1.61-1.93), and non-steroidal anti-inflammatory drugs (OR, 1.18; 95% CI, 1.07-1.29). Pelvic fractures within 1 year from the date of suicide death were statistically significantly associated with increased risk of suicide (adjusted OR [AOR], 2.65; 95% CI, 1.29-5.45; p = 0.008) compared to controls. The risk of suicide death declined as the incidence date of pelvic fracture was more remote from the date of suicide death: AORs of 2.59 (95% CI, 1.33-5.04; p = 0.005) within 2 years and 2.13 (95% CI, 1.15-3.95; p = 0.017) within 3 years. However, there was no statistical significance in the increased risk of suicide death for pelvic fractures that had occurred ≥ 4 years ago (p > 0.05).

Conclusions: Pelvic fractures in the elderly population increased the risk of suicide death within 3 years, suggesting the need for psychiatric support among elderly patients with pelvic fractures.
Files in This Item:
T202300783.pdf Download
DOI
10.4055/cios21190
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Jang, Suk Yong(장석용)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193205
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