© 1996 Oxford University Press
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New Evidence on Benzodiazepine Use and Falls: The Time Factor
1Risk Management & Regulatory Affairs, Drugs Directorate Health Canada, Ottawa, Ontario K1A 0L2, Canada
2Department of Health Studies and Gerontology, University of Waterloo and Grand River Hospital 3570 King Street East, Kitchener, Ontario N2A 2W1, Canada
3Clinical Epidemiology Unit, SCOHS-Elisabeth Bruyère Pavilion 43 Bruyère Street, Ottawa, Ontario, K1N 5C8, Canada
4Department of Psychiatry, Calgary General Hospital Calgary, Alberta, T2N 4N1 Canada
The objectives of this prospective study were to calculate incidence rates for fall-related hospitalization, to compare the effect of risk factors among benzodiazepine (BZD) users and unexposed controls, and to examine variations in risks according to length of time following a BZD prescription. Data were derived from Saskatchewan Health linked data bases, leading to information on 468 hospitalizations for injury due to falls among a study population of 321422.
Incidence rates per 10 000 within 28 days of the prescription fill date were 26.2, 12.1 and 9.0 for BZD sedative users, BZD tranquillizer users and for unexposed controls, respectively. Incidence rates increased with age, and were higher for women than for men. Results from multivariate logistic regression models also showed a greater risk of falling for BZD users but the odds ratio was higher for men than for women. A history of treatment for alcohol abuse was a very strong risk factor for falls among both men (odds ratio, 10.7) and women (odds ratio, 4.3).
The highest risk of serious injury due to falls was within 15 days of filling the prescription, with an odds ratio of 3.6 for BZD sedatives and 2.6 for BZD tranquillizers. Risk decreased with further increase of time after the BZD fill date. For the individual BZD, flurazepam and triazolam showed the highest increase in risk with odds ratios of 3.4 and 2.7, respectively, while oxazepam, lorazepam and diazepam showed odds ratios of 2.2, 2.0 and 1.8 (all odds ratios mentioned are statistically significant at p < 0.05).
Revision received November 23, 1995.
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