TABLE 2.
Incident Fracture Rates in Children and Young Adults Initiating Benzodiazepine or SSRI Treatment Over a Maximum of 3 Months on Treatment
| No. Persons | Primary Fracture (Upper and Lower Limb)a | Any Fractureb | ||||||
|---|---|---|---|---|---|---|---|---|
| No. Fracture Events | PY | Rate per 1000 PYs | IRR (95% CI) | No. Fracture Events | Rate per 1000 PYs | IRR (95% CI) | ||
| Children (6–17 y) | ||||||||
| Crude | 120 715 | 598 | 23 441 | 25.5 | — | 1162 | 49.7 | — |
| Benzodiazepine initiators | 12 840 | 38 | 1148 | 33.1 | 1.32 (0.95–1.83) | 66 | 57.6 | 1.17 (0.91–1.50) |
| SSRI initiators | 107 875 | 560 | 22 293 | 25.1 | Referent | 1096 | 49.3 | Referent |
| Adjustedc | ||||||||
| Benzodiazepine | 10 864 | 380 | 9871 | 38.5 | 1.53 (0.94–2.50) | 618 | 62.7 | 1.27 (0.88–1.82) |
| SSRI | 95 991 | 553 | 22 046 | 25.1 | Referent | 1088 | 49.5 | Referent |
| Stratified analysis, adjustedc | ||||||||
| Long-actingd benzodiazepine | 3480 | 562 | 9634 | 58.3 | 2.30 (1.08–4.91) | 884 | 92.0 | 1.84 (1.09–3.13) |
| SSRIe | 98 596 | 535 | 21 071 | 25.4 | Referent | 1049 | 49.9 | Referent |
| Short-acting benzodiazepine | 7184 | 279 | 9399 | 29.7 | 1.21 (0.54–2.70) | 443 | 47.2 | 0.96 (0.53–1.75) |
| SSRIe | 94 565 | 517 | 21 009 | 24.6 | Referent | 1029 | 49.1 | Referent |
| Young adults (18–24 y) | ||||||||
| Crude | 179 768 | 254 | 28 827 | 8.8 | — | 775 | 26.9 | — |
| Benzodiazepine initiators | 57 684 | 51 | 5896 | 8.7 | 0.98 (0.72–1.33) | 161 | 27.3 | 1.02 (0.86–1.21) |
| SSRI initiators | 122 084 | 203 | 22 931 | 8.9 | Referent | 614 | 26.8 | Referent |
| Adjustedc | ||||||||
| Benzodiazepine | 51 912 | 130 | 17 007 | 7.6 | 0.85 (0.57–1.27) | 447 | 26.4 | 0.97 (0.78–1.21) |
| SSRI | 109 690 | 269 | 30 084 | 8.9 | Referent | 814 | 27.1 | Referent |
| Stratified analysis, adjustedc | ||||||||
| Long-actingd benzodiazepine | 11 288 | 116 | 13 845 | 8.4 | 0.95 (0.49–1.84) | 372 | 26.9 | 0.99 (0.67–1.46) |
| SSRIe | 110 569 | 202 | 22 766 | 8.9 | Referent | 620 | 27.3 | Referent |
| Short-acting benzodiazepine | 39 974 | 111 | 15 255 | 7.3 | 0.80 (0.52–1.25) | 388 | 25.5 | 0.94 (0.73–1.23) |
| SSRIe | 108 959 | 252 | 27 779 | 9.1 | Referent | 748 | 27.0 | Referent |
—, not applicable.
a
Upper and lower limb fracture: fractures of the shoulder, upper arm, forearm, wrist, femur, lower leg, and/or ankle.
b
PYs under any fracture definition are not displayed and are similar to PYs under primary fracture definition.
c
Adjusted results: IPTW applied in trimmed cohort; total person count displayed is unweighted, and remaining displayed results are weighted.
d
Long-acting benzodiazepine is defined as initial prescription for chlordiazepoxide, clobazam, clorazepate, clonazepam, diazepam, or flurazepam.
e
SSRI reference group varies given reweighting or trimming in each stratified cohort.