Benzodiazepines and hip fractures in elderly people: case-control study

Objective To determine whether benzodiazepines are associated with an incre ased risk of hip facture. Design Case-control study. Participants All incident cases of hip fracture not related to traffic acci dents or cancer in patients ol er 65 years of age. 245 cases were matched t o 817 controls. Setting Emergency department of a university hospital. Main outcome measures Exposure to benzodiazepines and other potential risk ol protective factors or lifestyle items. Results The use of benzodiazepines as determined from questionnaires, medic al records, or plasma samples at admission to hospital was not associated w ith an increased risk of hip fracture (odds ratio 0.9, 95% confidence inter val 0.5 to 1.5). Hip fracture was, however, associated with the use of two of more benzodiazepines, as determined from questionnaires or medical recor ds but not from plasma samples. Of the individual drugs, only lorazepam was significantly associated with an increased risk of hip fracture (1.8, 1.1 to 3.1). Conclusion Except for lorazepam, the presence of benzodiazepines in plasma was not associated with an increased risk of hip fracture. nle method used to ascertain exposure could influence the results of case-control studies.