![]() In one study surveying suicide of elderly patients with spinal fractures in a nationwide cohort, the incidence rate of suicide death was 116 per 100,000 person-years in the whole follow-up period and 156 per 100,000 person-years within 1 year after fracture. The risk of suicide death after pelvic fractures increased up to 3 years after fracture, and the highest was 2.65 times within 1 year after fracture. Second, the incidence rate of suicide death was the highest within 1 year after fracture (285.3 per 100,000 person-years). The main findings of our study are as follows: First, the incidence rate of suicide death in elderly patients with pelvic fractures was 128.1 per 100,000 person-years during the whole observational period. ![]() SAS version 7.1 (SAS Institute, Cary, NC, USA) was used for all statistical analyses. ![]() Statistical significance was considered as a p-value < 0.05. Prescription of over 28 days for other medications was considered for the patients who had taken corresponding medications. History of opioid medication was classified by prescription days. 20) History of depression was defined as any prescription of antidepressants or presence of diagnostic code for depression within 1 year. Each subject’s number of comorbidities was assessed by diagnostic codes using an ICD-10 coding algorithm of the CCI score suggested by Quan. Besides the matching variables in the nested case-control study design, confounders that we adjusted for were medication history (antidiabetic agents, anti-hypertensive agents, benzodiazepines, opioids, lipid-lowering agents, steroids, anti-rheumatic agents, and non-steroidal anti-inflammatory agents, Cox-2 inhibitors, anti-platelet agents, anti-Parkinson medication, anti-Alzheimer medication, aspirin, anti-epileptic drugs, warfarin, and anti-psychotic drugs), past medical history (ischemic heart disease, neoplasm, stroke, depression, and chronic kidney disease), Charlson comorbidity index (CCI), number of outpatient visits, and socioeconomic variables (household income level, residential area, and registered disability), and the calendar year of suicide. The adjusted odds ratios (AORs) and 95% CIs were calculated. Association between pelvic fractures and the risk of suicide death was evaluated by conditional logistic regression analysis. The incidence rate of suicide (per 100,000 person-years) and 95% confidence interval (CI) among patients with pelvic fractures were estimated by a generalized linear model (with Poisson distribution). The purpose of this study was to investigate the incidence rate of suicide in elderly patients with pelvic fractures in a nationwide cohort and to analyze the change in the risk of suicide over time after pelvic fractures in comparison with controls. Also, they did not suggest the incidence rate of suicide death in elderly patients with pelvic fractures. 14) reported that the risk of suicide was twice as high after pelvic fractures, this study was conducted in patients over 40 years of age and included very high traumatic injuries, which are different from elderly pelvic fractures. Most reports on suicide-related pelvic fractures were focused on the type of pelvic fractures or clinical outcome after treatment. We hypothesized that this painful situation could increase the risk of suicide death in elderly patients. 11) reported there was a high risk of mental disorders such as depression, alcohol use, and posttraumatic stress syndrome in patients with pelvic fractures. 10, 11) Therefore, it seems natural for these patients to develop psychosocial problems. 8, 9) In addition, even after fracture recovery, it is reported that patients suffer from chronic pain, limited mobility, and sexual dysfunction, and the quality of life is reduced. 6) Articles on clinical outcomes after treatment of pelvic fractures have reported that pelvic fractures are associated with considerable morbidity, high mortality rates, and significant costs. 6, 7) Although fragility pelvic fractures are not considered as a major osteoporotic fracture, it is reported that the incidence of elderly pelvic fractures is increasing. 5)Īs the elderly population increases, the socioeconomic burden for osteoporotic fractures is a challenging issue in developed countries. 2) There are various factors that increase suicide, and physical diseases that cause chronic pain, disability and dependency, and high costs for treatment are also one of the major factors. ![]() 4) Thus, suicide in elderly patients is easy to be ignored. 2, 3) Elderly patients tend to be reticent about expressing their emotional stress, depression, or suicidal thoughts. 1) Several reports showed that suicide rates of elderly population in many countries were higher than those of young population. Suicide is one of the most important heath issues in the elderly population.
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