scholarly journals Hip Fracture Risk among Hemodialysis-Dependent Patients Prescribed Opioids and Gabapentinoids

2020 ◽  
Vol 31 (6) ◽  
pp. 1325-1334 ◽  
Author(s):  
Chandan Vangala ◽  
Jingbo Niu ◽  
Maria E. Montez-Rath ◽  
Jingyin Yan ◽  
Sankar D. Navaneethan ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
Conditional Logistic Regression ◽  
Opioid Analgesics ◽  
The United States ◽  
Opioid Use ◽  
Short Term ◽  
Part D ◽  
Hip Fracture Risk ◽  
Short Term Exposure

BackgroundDespite opioids’ known association with hip fracture risk in the general population, they are commonly prescribed to patients with ESKD. Whether use of opioids or gabapentinoids (also used to treat pain in patients with ESKD) contributes to hip fracture risk in patients with ESKD on hemodialysis remains unknown.MethodsIn a case-control study nested within the US Renal Data System, we identified all hip fracture events recorded among patients dependent on hemodialysis from January 2009 through September 2015. Eligible cases were risk-set matched on index date with ten eligible controls. We required >1 year of Medicare Parts A and B coverage and >3 years of part D coverage to study cumulative longer-term exposure. To examine new, short-term exposure, we selected individuals with >18 months of Part D coverage and no prior opioid or gabapentinoid use between 18 and 7 months before index. We used conditional logistic regression to estimate unadjusted and multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (95% CI).ResultsFor the longer-term analyses, we identified 4912 first-time hip fracture cases and 49,120 controls. Opioid use was associated with increased hip fracture risk (adjusted OR, 1.39; 95% CI, 1.26 to 1.53). Subgroups of low, moderate, and high use yielded adjusted ORs of 1.33 (95% CI, 1.20 to 1.47), 1.53 (95% CI, 1.36 to 1.72), and 1.66 (95% CI, 1.45 to 1.90), respectively. The association with hip fractures was also elevated with new, short-term use (adjusted OR, 1.38; 95% CI, 1.25 to 1.52). There were no associations between gabapentinoid use and hip fracture.ConclusionsAmong patients dependent on hemodialysis in the United States, both short-term and longer-term use of opioid analgesics were associated with hip fracture events.

scholarly journals Association between Anti-Psychotic Drugs Use and Hip Fractures in Patients with Dementia: A Nationwide Population-Based Study

2021 ◽  
Vol 18 (15) ◽  
pp. 8118
Author(s):  
Chia-Hung Tang ◽  
Yi-Chen Lai ◽  
Yi-Chen Chen ◽  
Shun-Min Chang ◽  
Yu-Han Chen ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
Hip Fractures ◽  
Conditional Logistic Regression ◽  
High Risk Group ◽  
Control Analysis ◽  
Hip Fracture Risk ◽  
People With Dementia ◽  
Increased Risk ◽  
Four Levels

Background: People with dementia are a high-risk group for hip fractures. Although the increased risk of hip fractures associated with antipsychotic drugs (APD) is found in older populations, little is known about the risk for people with dementia living in Asia. We aimed to investigate the association between hip fractures and the characteristics of APD use in patients with dementia. Methods: A nested case-control analysis was conducted on a nationwide cohort in Taiwan. People with diagnoses of dementia during 2003–2012 were identified. Conditional logistic regression analysis was performed, and adjusted odds ratios (aORs) were calculated with a 95% confidence interval (CI) to estimate the risk of hip fractures. Results: APD use was associated with an increased risk of hip fractures in patients with dementia; current use or combined use of first and second generations of APDs had even higher risks. Regarding the duration of APD use, a U-shape curve of hip fracture risk was noted, and the risk peaked during 0–15 days and >215 days of exposure (aOR = 1.46, 95% CI 1.37–1.57; aOR = 1.47, 95% CI 1.37–1.58; respectively). Considering the doses of APDs, the hip fracture risk was significantly increased with all four levels of the cumulative doses and average daily doses and peaked in the group with the highest average daily dose. Conclusions: The findings suggest that caution must be taken when initiating APD use in patients with dementia, even in a small dose, and mixed types of APD prescriptions should be administered with care. Furthermore, frequent evaluation of the possibility of tapering or withdrawal of the medication is necessary, as the risk does not attenuate after long-term use.

scholarly journals TNF Receptors Predict Hip Fracture Risk in the WHI Study and Fatty Acid Intake Does Not Modify This Association

2015 ◽  
Vol 100 (9) ◽  
pp. 3380-3387 ◽  
Author(s):  
Steven W. Ing ◽  
Tonya S. Orchard ◽  
Bo Lu ◽  
Michael J. LaMonte ◽  
Kamil E. Barbour ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Confidence Interval ◽  
Fracture Risk ◽  
Odds Ratio ◽  
Linear Trend ◽  
Conditional Logistic Regression ◽  
Cytokine Gene Expression ◽  
Soluble Receptors ◽  
Pufa Intake ◽  
Hip Fracture Risk

Context: Chronic inflammation may increase the risk of fracture, and omega-3 polyunsaturated fatty acids (PUFAs) may reduce fracture risk via down-regulation of inflammatory cytokine gene expression and other mechanisms. Objective: We investigated associations between baseline samples of inflammatory markers, TNFα soluble receptors 1 and 2 (TNFα-sR1 and -sR2), and incident hip fracture. These associations were then tested for effect modification by dietary PUFA intake estimated by a baseline food frequency questionnaire. Design and Setting: A nested case-control study was conducted among participants of the Women's Health Initiative Observational Study (ages, 50–79 y). Multivariable conditional logistic regression models were constructed to account for the paired design. Participants: This study sampled 400 pairs of hip fracture cases and controls without incident hip fracture, matched on age, year of enrollment, and menopausal hormone use. Main Outcome Measures: Odds ratio of hip fracture by quartile of TNF soluble receptors. Results: The odds ratio of hip fracture comparing the highest to lowest quartiles was 2.24 (95% confidence interval, 1.05–4.79; P for linear trend, .048) for TNFα-sR1 and 2.83 (95% confidence interval, 1.34–5.99; P for linear trend, .011) for TNFα-sR2, adjusted for FRAX hip fracture score, nutritional variables, and selected factors impacting inflammation; there was a gradient of risk by increasing quartile in TNFα-sR1. PUFA intake did not modify these associations. Conclusions: Women with the highest levels of TNFα-sR1 and TNFα-sR2 had a greater than 2-fold increased hip fracture risk, independent of other fracture risk factors. These associations did not differ by high vs low PUFA intake.

Socio-economic status and hip fracture risk: a region-wide ecological study

2014 ◽  
Author(s):  
Carlen Reyes ◽  
M Kassim Javaid ◽  
Cyrus Cooper ◽  
Adolfo Diez-Perez ◽  
Daniel Prieto-Alhambra
Keyword(s):  
Hip Fracture ◽  
Fracture Risk ◽  
Ecological Study ◽  
Economic Status ◽  
Hip Fracture Risk ◽  
Socio Economic Status

scholarly journals Effect of ambient fine particulates (PM2.5) on hospital admissions for respiratory and cardiovascular diseases in Wuhan, China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhan Ren ◽  
Xingyuan Liu ◽  
Tianyu Liu ◽  
Dieyi Chen ◽  
Kuizhuang Jiao ◽  
...  
Keyword(s):  
Air Pollution ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Conditional Logistic Regression ◽  
Warm Season ◽  
Central China ◽  
Air Pollution Control ◽  
Short Term ◽  
Short Term Exposure ◽  
Increased Risk

Abstract Background Positive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. However, few studies have examined the adverse effects of PM2.5 based on an entire population of a megalopolis. In addition, most studies in China have used averaged data, which results in variations between monitoring and personal exposure values, creating an inherent and unavoidable type of measurement error. Methods This study was conducted in Wuhan, a megacity in central China with about 10.9 million people. Daily hospital admission records, from October 2016 to December 2018, were obtained from the Wuhan Information center of Health and Family Planning, which administrates all hospitals in Wuhan. Daily air pollution concentrations and weather variables in Wuhan during the study period were collected. We developed a land use regression model (LUR) to assess individual PM2.5 exposure. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate cardiorespiratory hospitalization risks associated with short-term exposure to PM2.5. We also conducted stratification analyses by age, sex, and season. Results A total of 2,806,115 hospital admissions records were collected during the study period, from which we identified 332,090 cardiovascular disease admissions and 159,365 respiratory disease admissions. Short-term exposure to PM2.5 was associated with an increased risk of a cardiorespiratory hospital admission. A 10 μg/m3 increase in PM2.5 (lag0–2 days) was associated with an increase in hospital admissions of 1.23% (95% CI 1.01–1.45%) and 1.95% (95% CI 1.63–2.27%) for cardiovascular and respiratory diseases, respectively. The elderly were at higher PM-induced risk. The associations appeared to be more evident in the cold season than in the warm season. Conclusions This study contributes evidence of short-term effects of PM2.5 on cardiorespiratory hospital admissions, which may be helpful for air pollution control and disease prevention in Wuhan.

Body composition and hip fracture risk in older women: A prospective study

1996 ◽  
Vol 6 (S1) ◽  
pp. 132-132
Author(s):  
K. E. Ensrud ◽  
R. C. Lipschutz ◽  
J. A. Cauley ◽  
M. C. Nevitt ◽  
S. R. Cummings ◽  
...  
Keyword(s):  
Body Composition ◽  
Hip Fracture ◽  
Prospective Study ◽  
Fracture Risk ◽  
Older Women ◽  
Hip Fracture Risk ◽  
A Prospective Study
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