Table E4.
HRs (99% CIs) for association between atopic eczema and fractures for main and sensitivity analyses
| Analysis | No. of individuals | Person-years at risk | No. of fracture events | HR∗ (99% CI) for fracture risk in those with atopic eczema compared with those without |
|
|---|---|---|---|---|---|
| Adjusted for potential confounders† | Additionally adjusted for potential mediators‡ | ||||
| Any fracture | |||||
| Main analysis | 2,978,407 | 17,265,591 | 224,016 | 1.10 (1.08-1.12) | 1.08 (1.06-1.10) |
| Additionally adjusted for ethnicity and restricted to those entering the cohort after 2006 | 640,317 | 2,105,275 | 18,576 | 1.06 (0.98-1.15) | 1.04 (0.95-1.15) |
| Redefined cohort 1 (unexposed pool of subjects included those with a diagnosis of atopic eczema but without 2 records of treatment) | 2,912,218 | 16,985,396 | 221,985 | 1.10 (1.08-1.11) | 1.07 (1.05-1.09) |
| Redefined cohort 2 (included all patients with an atopic eczema diagnosis code) | 3,509,617 | 21,050,236 | 260,151 | 1.09 (1.07-1.10) | 1.06 (1.04-1.09) |
| Restricting the cohort to those with newly diagnosed eczema and their matched counterparts | 324,119 | 1,580,515 | 23,009 | 1.11 (1.05-1.16) | 1.09 (1.04-1.16) |
| Restricting the cohort to those who have consulted their general practitioner at least once in the year before cohort entry | 2,375,594 | 13,937,539 | 192,760 | 1.05 (1.04-1.07) | 1.04 (1.02-1.06) |
| Hip fractures | |||||
| Main analysis | 2,978,603 | 18,175,267 | 38,414 | 1.10 (1.06-1.14) | 1.07 (1.03-1.12) |
| Hip fractures excluding those a with history of any other fracture | 2,634,138 | 15,078,531 | 27,821 | 1.10 (1.06-1.16) | 1.09 (1.03-1.14) |
| Pelvic fractures | |||||
| Main analysis | 2,978,623 | 18,254,948 | 9,260 | 1.10 (1.02-1.19) | 1.08 (0.99-1.18) |
| Pelvic fractures excluding those with history of any other fracture | 2,740,367 | 16,216,496 | 7,422 | 1.07 (0.97-1.17) | 1.04 (0.94-1.15) |
| Spinal fractures | |||||
| Main analysis | 2,978,621 | 18,245,116 | 11,155 | 1.18 (1.10-1.27) | 1.17 (1.09-1.26) |
| Spinal fractures excluding those with a history of any other fracture | 2,742,247 | 16,227,594 | 9,180 | 1.09 (1.01-1.18) | 1.09 (1.00-1.19) |
| Wrist fractures | |||||
| Main analysis | 2,978,611 | 18,134,891 | 31,278 | 1.07 (1.03-1.11) | 1.06 (1.02-1.11) |
| Wrist fractures excluding those with a history of any other fracture | 2,759,460 | 16,294,062 | 26,329 | 1.00 (0.93-1.07) | 1.01 (0.94-1.08) |
| Proximal humeral fracture | |||||
| Main analysis | 2,978,624 | 18,254,284 | 8,040 | 1.06 (0.97-1.15) | 1.05 (0.94-1.15) |
| Proximal humeral fractures excluding those with a history of any other fracture | 2,738,861 | 16,206,684 | 6,402 | 0.93 (0.84-1.03) | 0.92 (0.83-1.02) |
| Restricting to more specific codes for proximal humeral fracture | 3,095,632 | 18,255,196 | 8,895 | 0.95 (0.88-1.03) | 0.97 (0.89-1.06) |
Estimated HRs from Cox regression with current age as the underlying timescale stratified by matched set (matched on age at cohort entry, sex, general practice, and date at cohort entry). All models fitted to individuals with complete data for all variables included in each model and from valid matched sets, including 1 individual with atopic eczema and at least 1 individual without atopic eczema. All models implicitly adjusted for sex, date at cohort entry, and practice (because of stratification by matched set) and age (because of underlying timescale).
Additionally adjusted for potential confounders: time-updated asthma, IMD, and calendar time.
Further adjusted for possible mediators of the relationship between fractures and atopic eczema: BMI, smoking status, harmful alcohol use, and high-dose oral glucocorticoid use.