Vertebral fracture as a risk factor for self-harm: a retrospective cohort study.
BACKGROUND: The prevention of self-harm is an international public health priority. It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures.
METHODS: Retrospective cohort study. Patients with vertebral fracture were identified within the Clinical Practice Research Datalink and matched to patients without fracture by sex and age. Incident self-harm was defined by primary care record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95 % confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by median age and sex.
RESULTS: The number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1 %), median age was 76.3 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95 %CI 1.5, 3.6). Greatest risk of self-harm was found in those with vertebral fractures who were aged below 76.3 years (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)).
CONCLUSIONS: Primary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Male patients aged below 76 years of age appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.
|投稿者||Prior, James A; Crawford-Manning, Fay; Whittle, Rebecca; Abdul-Sultan, Alyshah; Chew-Graham, Carolyn A; Muller, Sara; Shepherd, Tom A; Sumathipala, Athula; Mallen, Christian D; Paskins, Zoe|
|ジャーナル名||BMC musculoskeletal disorders|
|組織名||Primary Care Centre Versus Arthritis, School of Medicine, Keele University, ST5;5BG, Staffordshire, UK. email@example.com.;Midlands Partnership NHS Foundation Trust, Stafford, UK. firstname.lastname@example.org.;5BG, Staffordshire, UK.;Midlands Partnership NHS Foundation Trust, Stafford, UK.;Haywood Academic Rheumatology Centre, Midland Partnership NHS Foundation Trust,;ST6 7AG, Stoke-on-Trent, UK.|