Fractures as a suicidal behavior risk factor: A nationwide population-based cohort study

Area of Science:

• Medical research
• Psychiatry
• Public Health

Background:

• Fracture history is a significant public health concern.
• Understanding the long-term mental health implications of fractures is crucial.

Purpose of the Study:

• To investigate the association between fracture history and the subsequent risk of suicidal behavior.
• To analyze the temporal trends and specific risk factors associated with suicidal behavior after fractures.

Main Methods:

• A cohort study involving 82,804 patients with fractures and 82,804 matched controls without fractures.
• Utilized Cox proportional hazards modeling to assess the risk of suicidal behavior-related hospital visits.
• Analyzed risk based on age, comorbidities (stroke, sleep disorder), and number of fractures.

Main Results:

• Fracture patients exhibited a 2.21-fold increased risk of suicidal behavior-related hospital visits.
• The adjusted hazard ratio (aHR) decreased from 2.90 at 1 year to 2.00 after 5 years but remained elevated.
• Elevated risk was noted in patients younger than 35, those with stroke or sleep disorders, and individuals with multiple fractures (aHR 1.69).

Conclusions:

• Fractures are an independent risk factor for suicidal behavior.
• Specific subgroups, including younger individuals and those with comorbidities or multiple fractures, face a higher burden.
• The increased risk of suicidal behavior following a fracture is a long-term concern, persisting beyond five years.