Evidence map›Paper›PMID 24810612›Full record

ArticleEuropean journal of clinical pharmacology2014

Risk of hip fracture among older people using anxiolytic and hypnotic drugs: a nationwide prospective cohort study.

Marit Stordal Bakken, Anders Engeland, Lars B Engesæter, Anette Hylen Ranhoff, Steinar Hunskaar, Sabine Ruths

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In one paragraph

Article in European journal of clinical pharmacology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  4. Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019
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  6. Zolpidem use and risk of fractures: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Marit Stordal BakkenDepartment of Global Public Health and Primary Care, University of Bergen, PB 7804, 5020, Bergen, Norway, marit.bakken@igs.uib.no.
Anders Engeland
Lars B Engesæter
Anette Hylen Ranhoff
Steinar Hunskaar
Sabine Ruths

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAnxiolytics and hypnotics are widely used and may cause injurious falls. We aimed to examine associations between exposure to anxiolytics and hypnotics and the risk of hip fracture among all older people in Norway. Further, we wanted to examine associations between exposure to hypnotics and time of fracture.

methodsA nationwide prospective cohort study of people in Norway born before 1945 (n=906,422) was conducted. We obtained information on all prescriptions of anxiolytics and hypnotics dispensed in 2004-2010 (the Norwegian Prescription Database) and all primary hip fractures in 2005-2010 (the Norwegian Hip Fracture Registry). We compared the incidence rates of hip fracture during drug exposure and non-exposure by calculating the standardized incidence ratio (SIR).

resultsAltogether, 39,938 people (4.4%) experienced a primary hip fracture. The risk of hip fracture was increased for people exposed to anxiolytics (SIR 1.4, 95% confidence interval (CI) 1.4-1.5) and hypnotics (SIR 1.2, 95% CI 1.1-1.2); the excess risk was highest regarding short-acting benzodiazepine anxiolytics (SIR 1.5, 95% CI 1.4-1.6). Benzodiazepine-like hypnotics (z-hypnotics) were associated with higher excess risk of hip fracture at night (SIR 1.3, 95% CI 1.2-1.4) than during the day (SIR 1.1, 95% CI 1.1-1.2).

conclusionsOlder people had an increased risk of hip fracture during anxiolytic or hypnotic drug use, including short-acting benzodiazepine anxiolytics and z-hypnotics that were previously considered less harmful; cautious prescribing is therefore needed. People using z-hypnotics were at greatest excess risk at night; this association deserves further investigation.

Indexed as

Accidental FallsAgedAged, 80 and overAge FactorsAnti-Anxiety AgentsDrug PrescriptionsFemaleHip FracturesHumansHypnotics and SedativesIncidenceMaleMiddle AgedNorwayProspective StudiesRegistriesAnti-Anxiety AgentsHypnotics and Sedatives

Identifiers

PMID24810612
PMCPMC4053597

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.