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. 2019 Nov 28;9(11):e027581.
doi: 10.1136/bmjopen-2018-027581.

Evaluation of the increased risk of spine fracture in patients with mood disorder compared with matched controls: a longitudinal follow-up study using a national sample cohort in Korea

So Young Kim  1 , Chanyang Min  2 , Bumjung Park  3 , Miyoung Kim  4 , Hyo Geun Choi  5   3
Affiliations

Evaluation of the increased risk of spine fracture in patients with mood disorder compared with matched controls: a longitudinal follow-up study using a national sample cohort in Korea

So Young Kim et al. BMJ Open. .

Abstract

Objective: To evaluate the risk of spine fracture in patients with mood disorder using a nationwide cohort.

Design: A longitudinal follow-up study.

Setting: Claims data for the population ≥20 years of age were collected from 2002 to 2013 for the Korean National Health Insurance Service-National Sample Cohort.

Participants: A total of 60 140 individuals with mood disorder were matched with 240 560 individuals (control group) for age, sex, income, region of residence and osteoporosis.

Interventions: In both the mood disorder and control groups, the history of spine fracture was evaluated. The International Classification of Diseases 10th Revision codes for mood disorder (F31-F39) and spine fracture (S220 and S320) were included.

Primary and secondary outcome measures: The univariable and multivariable HRs and 95% CIs of spine fracture for patients with mood disorder were analysed using a stratified Cox proportional hazards model. Subgroup analyses were conducted according to the history of osteoporosis, age and sex.

Results: Approximately 3.3% (2011/60 140) of patients in the mood disorder group and 2.8% (6795/240 560) of individuals in the control group had spine fracture (p<0.001). The mood disorder group demonstrated a higher adjusted HR for spine fracture than the control group (multivariable HR=1.10, 95% CI 1.04 to 1.15, p<0.001). The participants without osteoporosis showed a higher HR of mood disorder for spine fracture than the control participants (multivariable HR=1.25, 95% CI 1.14 to 1.37, p<0.001). According to age and sex, this result was consistent in subgroups of women aged 20-39 and 40-59 years and men aged ≥60 years.

Conclusion: The risk of spine fracture was increased in patients with mood disorder. The potential risk of spine fracture needs to be evaluated when managing patients with mood disorder.

Keywords: cohort studies; depression; epidemiology; fractures.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Schematic illustration of the participant selection process that was used in the present study. Of a total of 1 125 691 participants, 60 140 patients with mood disorder were matched with 240 560 control participants by age, group, sex, income group, region of residence and osteoporosis.
Figure 2
Figure 2
Kaplan-Meier curve of spine fracture for depression. This was explained as a survival function curve.
See this image and copyright information in PMC

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