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Risk of hip fractures in patients with depressive disorders: A nationwide, population-based, retrospective, cohort study.

Risk of hip fractures in patients with depressive disorders: A nationwide, population-based, retrospective, cohort study.
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Pan CC, Hu LY, Lu T, Tu MS, Shen CC, Chen ZJ,


Pan CC, Hu LY, Lu T, Tu MS, Shen CC, Chen ZJ, (click to view)

Pan CC, Hu LY, Lu T, Tu MS, Shen CC, Chen ZJ,

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PloS one 2018 04 1113(4) e0194961 doi 10.1371/journal.pone.0194961
Abstract
BACKGROUND
Some studies have suggested that depressive disorders may play a vital role in the incidence of hip fractures. However, nationwide data are lacking regarding the association between depressive disorders and hip fractures.

OBJECTIVE
We aimed to explore the association between depressive disorders and new-onset hip fractures.

METHODS
We conducted a retrospective study of 11,207 patients with depressive disorders and 11,207 control patients using Taiwan’s National Health Insurance Research Database. A Cox regression model was used to evaluate the risk of hip fractures in patients with depressive disorders.

RESULTS
The incidence rate ratio of hip fractures between patients with depressive disorders and controls was 1.6 (95% confidence interval [CI] = 1.29-1.99, P < .001). After adjustment for potential confounders in multivariate analysis using the Cox regression model, patients with depressive disorders were found to have 1.34 times higher risk of hip fractures than controls (95% CI = 1.08-1.66, P = .008). Furthermore, age (hazard ratio [HR] = 7.43, 95% CI = 4.94-11.19, P < .001), hypertension (HR = 1.63, 95% CI = 1.17-2.28, P = .004), diabetes mellitus (HR = 1.47, 95% CI = 1.08-1.99, P = .014), cerebrovascular disease (HR = 1.76, 95% CI = 1.31-2.35, P < .001), living in rural areas (HR = 1.88, 95% CI = 1.30-2.70, P = .001), and low monthly income (NT$0-NT$19,000: HR = 4.08, 95% CI = 1.79-9.29, P = .001 and NT$19,100-NT$42,000: HR = 4.09, 95% CI = 1.76-9.49, P = .001) were independent risk factors for new-onset hip fractures in patients with depressive disorders. CONCLUSION
Depressive disorders might increase the risk of new-onset hip fractures, particularly in older patients and patients with hypertension, diabetes mellitus, cerebrovascular disease, or low socioeconomic status.

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