TY - JOUR PY - 2021// TI - Vertebral fracture as a risk factor for self-harm: a retrospective cohort study JO - BMC musculoskeletal disorders A1 - Prior, James A. A1 - Crawford-Manning, Fay A1 - Whittle, Rebecca A1 - Abdul-Sultan, Alyshah A1 - Chew-Graham, Carolyn A. A1 - Muller, Sara A1 - Shepherd, Tom A. A1 - Sumathipala, Athula A1 - Mallen, Christian D. A1 - Paskins, Zoe SP - e757 EP - e757 VL - 22 IS - 1 N2 - BACKGROUND: The prevention of self-harm is an international public health priority. It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures.

METHODS: Retrospective cohort study. Patients with vertebral fracture were identified within the Clinical Practice Research Datalink and matched to patients without fracture by sex and age. Incident self-harm was defined by primary care record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95 % confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by median age and sex.

RESULTS: The number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1 %), median age was 76.3 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95 %CI 1.5, 3.6). Greatest risk of self-harm was found in those with vertebral fractures who were aged below 76.3 years (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)).

CONCLUSIONS: Primary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Male patients aged below 76 years of age appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.

Language: en

LA - en SN - 1471-2474 UR - http://dx.doi.org/10.1186/s12891-021-04631-9 ID - ref1 ER -