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우리나라 노인의 수면제 복용과 골절 발생의 상관성 분석
장윤욱,한은아,최재우,강혜영 한국보건사회약료경영학회 2022 한국보건사회약료경영학회지 Vol.10 No.1
OBJECTIVE To investigate association between the use of sedative-hypnotics and fractures in the Korean elderly population. METHODS We used 2016 Health Insurance Review and Assessment Service-the Adult Patient Sample (HIRA-APS) data, which was extracted from 20% of the elderly patients over 65 years old. We excluded individuals diagnosed with fractures, osteoporosis, or car accidents during a wash-out period (i.e., January - March). Then, patients with at least one claim record with prescribed sedative-hypnotics from April through December were defined as those treated with sedative-hypnotics. If there was at least one claim record with a diagnosis of fracture during the same time period, then we defined a fracture incidence. RESULTS A multivariate logistic regression analysis result showed that the elderly prescribed with sedative-hypnotics had a significantly higher risk of fractures by 1.337 times (adjusted odds ratio (aOR)=1.337, 95% confidence interval (CI): 1.316-1.358). Also, the risk of fractures significantly increased as the number of sedative-hypnotics prescribed increased (aOR of taking one sedative-hypnotics vs. none: 1.255 (95% CI: 1.233-1.278), aOR of two sedativehypnotics: 1.464 (95% CI: 1.425-1.504), and aOR of three or more sedative-hypnotics: 1.720 (95% CI: 1.652-1.790). CONCLUSION A significant association between the use of sedative-hypnotics and the risk of fractures and its dose-response relationship among Korean elderly population were confirmed based on a nationally representative data of HIRA-APS. Our results suggest careful use of sedative-hypnotics to treat elderly population. Especially, when it is necessary to prescribe multiple sedative- hypnotics for the elderly, a close monitoring should be accompanied to prevent fractures.
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