TY - JOUR
T1 - Predictors of falls and fractures leading to hospitalisation in 36 101 people with affective disorders
T2 - a large representative cohort study
AU - Ma, Ruimin
AU - Perera, Gayan
AU - Romano, Eugenia
AU - Vancampfort, Davy
AU - Koyanagi, Ai
AU - Stewart, Robert
AU - Mueller, Christoph
AU - Stubbs, Brendon
N1 - Funding Information:
Funding BS is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). BS is also supported by an NIHR Advanced fellowship (NIHR301206, 2021-2026). Brendon Stubbs is on the Editorial board of Ageing Research Reviews, Mental Health and Physical Activity, The Journal of Evidence Based Medicine and The Brazilian Journal of Psychiatry. Brendon has received honorarium from a co-edited a book on exercise and mental illness and advisory work from ASICS for unrelated work. RM and ER were supported by a grant from Guy's & St Thomas' Charity.RS receive salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, and RS is a NIHR Senior Investigator and is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust.
Publisher Copyright:
© 2022 BioMed Central Ltd.. All rights reserved.
PY - 2022/3/11
Y1 - 2022/3/11
N2 - OBJECTIVES: To investigate predictors of falls and fractures leading to hospitalisation in people with affective disorders. DESIGN: Cohort study. SETTING: The South London and Maudsley National Health Service (NHS) Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register. PARTICIPANTS: A large cohort of people with affective disorders (International Classification of Diseases- 10th version [ICD-10] codes F30-F34) diagnosed between January 2008 and March 2016 was assembled using data from the SLaM BRC Case Register. PRIMARY AND SECONDARY OUTCOME MEASURES: Falls and fractures leading to hospitalisation were ascertained from linked national hospitalisation data. Multivariable Cox proportional hazards analyses were administrated to identify predictors of first falls and fractures. RESULTS: Of 36 101 people with affective disorders (mean age 44.4 years, 60.2% female), 816 (incidence rate 9.91 per 1000 person-years) and 1117 (incidence rate 11.92 per 1000 person-years) experienced either a fall or fracture, respectively. In multivariable analyses, older age, analgesic use, increased physical illness burden, previous hospital admission due to certain comorbid physical illnesses and increase in attendances to accident and emergency services following diagnosis were significant risk factors for both falls and fractures. Having a history of falls was a strong risk factor for recurrent falls, and a previous fracture was also associated with future fractures. CONCLUSIONS: Over a mean 5 years' follow-up, approximately 8% of people with affective disorders were hospitalised with a fall or fracture. Several similar factors were found to predict risk of falls and fracture, for example, older age, comorbid physical disorders and analgesic use. Routine screening for bone mineral density and fall prevention programmes should be considered for this clinical group.
AB - OBJECTIVES: To investigate predictors of falls and fractures leading to hospitalisation in people with affective disorders. DESIGN: Cohort study. SETTING: The South London and Maudsley National Health Service (NHS) Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register. PARTICIPANTS: A large cohort of people with affective disorders (International Classification of Diseases- 10th version [ICD-10] codes F30-F34) diagnosed between January 2008 and March 2016 was assembled using data from the SLaM BRC Case Register. PRIMARY AND SECONDARY OUTCOME MEASURES: Falls and fractures leading to hospitalisation were ascertained from linked national hospitalisation data. Multivariable Cox proportional hazards analyses were administrated to identify predictors of first falls and fractures. RESULTS: Of 36 101 people with affective disorders (mean age 44.4 years, 60.2% female), 816 (incidence rate 9.91 per 1000 person-years) and 1117 (incidence rate 11.92 per 1000 person-years) experienced either a fall or fracture, respectively. In multivariable analyses, older age, analgesic use, increased physical illness burden, previous hospital admission due to certain comorbid physical illnesses and increase in attendances to accident and emergency services following diagnosis were significant risk factors for both falls and fractures. Having a history of falls was a strong risk factor for recurrent falls, and a previous fracture was also associated with future fractures. CONCLUSIONS: Over a mean 5 years' follow-up, approximately 8% of people with affective disorders were hospitalised with a fall or fracture. Several similar factors were found to predict risk of falls and fracture, for example, older age, comorbid physical disorders and analgesic use. Routine screening for bone mineral density and fall prevention programmes should be considered for this clinical group.
KW - adult psychiatry
KW - anxiety disorders
KW - depression & mood disorders
KW - mental health
UR - http://www.scopus.com/inward/record.url?scp=85126389068&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-055070
DO - 10.1136/bmjopen-2021-055070
M3 - Article
C2 - 35277405
AN - SCOPUS:85126389068
SN - 2044-6055
VL - 12
SP - e055070
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e055070
ER -