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Mayo Clin Proc. 2014 May;89(5):589-94. doi: 10.1016/j.mayocp.2014.01.021. Epub 2014 Mar 29.

Long-term use of zolpidem increases the risk of major injury: a population-based cohort study.

Author information

1
Department of Family Medicine, China Medical University & Hospital, Taichung, Taiwan.
2
Department of Family Medicine, China Medical University & Hospital, Taichung, Taiwan; Institute of Health Care Administration, College of Public Health, China Medical University & Hospital, Taichung, Taiwan; Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan.
3
Management Office for Health Data, China Medical University & Hospital, Taichung, Taiwan.
4
Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan; Graduate Institute of Biostatistics & Chinese Medicine Science and Biostatistics Center, China Medical University, Taichung, Taiwan.
5
Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.

Abstract

OBJECTIVE:

To estimate the risk of head injury or fracture requiring hospitalization in patients treated with zolpidem.

PATIENTS AND METHODS:

We identified 8188 patients 18 years and older who had received a first prescription for zolpidem between January 1, 2000, and December 31, 2009, and compared them with 32,752 age- and sex-matched patients who had not used sedative-hypnotic agents. Both cohorts were followed up for at least 1 year or until hospitalization for head injury or fracture (major injury). Hazard ratios (HRs) and 95% CIs were calculated by comparing the incidence of major injury requiring hospitalization between the zolpidem user and comparison cohorts, including age groups 18 to 54 and 55 years or more, using a Cox proportional hazards regression analysis.

RESULTS:

The adjusted HR for major injury in zolpidem users was 1.67 (95% CI, 1.19-2.34). The adjusted HR for major injury in zolpidem users in the younger cohort (aged 18-54 years) was 1.70 (95% CI, 1.15-2.51) and in the older cohort (aged ≥55 years) was 1.57 (95% CI, 0.78-3.13). The adjusted HR for major injury in zolpidem users increased when the zolpidem dosage increased (HR, 2.04; 95% CI, 1.32-3.13 for 71-800 mg/y; HR, 4.37; 95% CI, 2.12-9.01 for 801-1600 mg/y; and HR, 4.74; 95% CI, 2.38-9.42 for >1600 mg/y).

CONCLUSION:

The long-term use of zolpidem is associated with a significantly greater risk of head injury or fracture requiring hospitalization than in patients who do not use sedative-hypnotic agents (P<.001), particularly in the younger (aged 18-54 years) patients.

Comment in

PMID:
24684782
DOI:
10.1016/j.mayocp.2014.01.021
[Indexed for MEDLINE]

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