Corticosteroid Is Associated with Both Hip Fracture and Fracture-Unrelated Arthropathy

• Published in: PloS one 2017-01, Vol.12 (1), p.e0169468-e0169468
• Main Authors: Kao, Feng-Chen, Hsu, Yao-Chun, Lin, Chien-Fu Jeff, Lo, Ying-Ying, Tu, Yuan-Kun
• Format: Article
• Language: English
• Subjects: Adjustment; Adolescent; Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - adverse effects; Adult; Aged; Aged, 80 and over; Arthritis; Arthroplasty (hip); Arthroplasty, Replacement, Hip; Biology and Life Sciences; Biomedical materials; Care and treatment; Complications and side effects; Confidence intervals; Corticosteroid drugs; Corticosteroids; Dosage and administration; Drug Administration Schedule; Female; Hip; Hip fractures; Hip Fractures - epidemiology; Hip Fractures - etiology; Hip Fractures - mortality; Hip Fractures - surgery; Hip joint; Hip replacement arthroplasty; Humans; Inflammation - drug therapy; Insurance; Joint Diseases - epidemiology; Joint Diseases - etiology; Joint Diseases - mortality; Joint Diseases - surgery; Joint surgery; Kaplan-Meier Estimate; Longitudinal Studies; Male; Medicine and Health Sciences; Middle Aged; National Health Programs; Osteoporosis; People and Places; Physical Sciences; Population studies; Proportional Hazards Models; Regression analysis; Risk Factors; Statistical analysis; Surgery; Surgical implants; Taiwan - epidemiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0169468

We aimed to investigate whether and how corticosteroid use was associated with serious hip arthropathy. This population-based cohort study analyzed the Taiwan National Health Insurance Research Database and screened the one-million random sample from the entire population for eligibility. The steroid cohort consisted of 21,995 individuals who had used systemic corticosteroid for a minimum of 6 months between January 1, 1997 and December 31, 2006. They were matched 1:1 in propensity score on the index calendar date with controls who never used steroid. All participants were followed up until occurrence of serious hip arthropathy that required arthroplasty, withdrawal from the national health insurance, or the end of 2011. Surgical indication was classified as fracture-related and -unrelated. The cumulative incidence of hip arthroplasty was estimated by the Kaplan Meier method. The association with steroid exposure was explored by the Cox proportional hazard model. Cumulative incidences of hip arthroplasty after 12 years of follow-up were 2.96% (95% confidence interval [CI], 2.73-3.2%) and 1.34% (95% CI, 1.2-1.51%) in the steroid users and non-users, respectively (P