Use of Selective Serotonin Reuptake Inhibitors and Risk of Hip Fracture in the Elderly: A Case-Control Study in Taiwan.
BACKGROUND
This population based study investigated the relationship between use of selective serotonin reuptake inhibitors (SSRIs) and hip fractures in the elderly in Taiwan.


METHODS
Analysis of a random sample of 1 million insurance enrollees' data identified 4,891 patients with newly diagnosed hip fractures and 4,891 controls without hip fracture between 2000 and 2011. Both cases and controls were ≥65 years of age and were matched by sex, age, comorbidities, and index year of hip fracture diagnosis. Patients were considered current SSRI users if their last SSRI tablet was taken ≤7 days before the hip fracture diagnosis. Late use of SSRIs was defined as taking the last SSRI tablet ≥8 days before the hip fracture diagnosis. Non-SSRI users comprised individuals who never had an SSRI prescription. Odds ratios (ORs) and 95% confidence intervals (CIs) for hip fracture associated with SSRI use was estimated by multivariate unconditional logistic regression.


RESULTS
After adjustment for covariants, multivariate regression analysis showed that the adjusted OR of hip fracture was 2.17 for current SSRI users (95% CI: 1.60-2.93) compared with those who never used SSRIs. The adjusted OR was 1.11 for individuals with late use of SSRIs (95% CI: 0.96-1.28) and was not significant.


CONCLUSIONS
Current use of SSRIs was associated with a 2.17-fold increase in the odds of hip fracture in the elderly in Taiwan. Clinicians should consider the possibility of SSRI-associated hip fracture among old people currently taking SSRIs.
Department of Emergency Medicine, Nantou Hospital, Nantou, Taiwan.
Shih-Chang
SC
Hung
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
Chih-Hsueh
CH
Lin
Department of Internal Medicine, Nantou Hospital, Nantou, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
Hung-Chang
HC
Hung
College of Medicine, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Cheng-Li
CL
Lin
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan. Electronic address: wei@mail.cmuh.org.tw.
Shih-Wei
SW
Lai
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D013624:Taiwan / Q000453:epidemiology
D017367:Selective Serotonin Reuptake Inhibitors
Adverse effect; epidemiology; fall