Benzodiazepine Use and Long-Term Mortality in South Korean Adult Population: A Cohort Study
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Purpose: Studies have reported mixed results on the association between benzodiazepine use and mortality. Here, we investigatedwhether benzodiazepine use is associated with a higher risk of 5-year all-cause mortality, and examined the association betweenbenzodiazepine use and 5-year disease-specific mortality. Materials and Methods: In this population-based cohort study, a nationally representative sample cohort in South Korea was examined. In 2010, benzodiazepine users were defined as individuals prescribed benzodiazepine continuously over 30 days for regularadministration, and all other subjects were included in the control group. The primary endpoint was 5-year all-cause mortality,evaluated from 2011 to 2015. Propensity score (PS) matching and time-dependent Cox regression were performed for statisticalanalysis, which included benzodiazepine use during 2011–2015 as a time-dependent variable. Results: A total of 822414 adult individuals were included in the final analysis, and the all-cause 5-year mortality was recorded in20991 individuals (2.7%). The benzodiazepine group included 30837 patients and the control group comprised 791377 patients. After PS matching, 61672 individuals (30836 in each group) were included in the final analysis. After PS matching, the 5-year allcausemortality in the benzodiazepine group was 10.0% (3082/30836), whereas that in the control group was 9.4% (2893/30836). In time-dependent Cox regression analysis of the PS-matched cohort, the benzodiazepine group showed 1.15-fold higher 5-yearall-cause mortality (hazard ratio: 1.15, 95% confidence interval: 1.09–1.22; p<0.001) compared to the control group. Conclusion: Benzodiazepine use was associated with increased 5-year all-cause mortality in the South Korean adult population. Further studies are needed to confirm these findings.
Abstract
Purpose: Studies have reported mixed results on the association between benzodiazepine use and mortality. Here, we investigatedwhether benzodiazepine use is associated with a higher risk of 5-year all-cause mortality, and examined the association betweenbenzodiazepine use and 5-year disease-specific mortality. Materials and Methods: In this population-based cohort study, a nationally representative sample cohort in South Korea was examined. In 2010, benzodiazepine users were defined as individuals prescribed benzodiazepine continuously over 30 days for regularadministration, and all other subjects were included in the control group. The primary endpoint was 5-year all-cause mortality,evaluated from 2011 to 2015. Propensity score (PS) matching and time-dependent Cox regression were performed for statisticalanalysis, which included benzodiazepine use during 2011–2015 as a time-dependent variable. Results: A total of 822414 adult individuals were included in the final analysis, and the all-cause 5-year mortality was recorded in20991 individuals (2.7%). The benzodiazepine group included 30837 patients and the control group comprised 791377 patients. After PS matching, 61672 individuals (30836 in each group) were included in the final analysis. After PS matching, the 5-year allcausemortality in the benzodiazepine group was 10.0% (3082/30836), whereas that in the control group was 9.4% (2893/30836). In time-dependent Cox regression analysis of the PS-matched cohort, the benzodiazepine group showed 1.15-fold higher 5-yearall-cause mortality (hazard ratio: 1.15, 95% confidence interval: 1.09–1.22; p<0.001) compared to the control group. Conclusion: Benzodiazepine use was associated with increased 5-year all-cause mortality in the South Korean adult population. Further studies are needed to confirm these findings.
참고문헌 (32)
- Schmitz A, "Benzodiazepine use, misuse, and abuse : a review", Ment Health Clin, 6, pp.120~126 (2016)
- Olfson M, "Benzodiazepine use in the United States", JAMA Psychiatry, 72, pp.136~142 (2015)
- Bachhuber MA, "Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013", Am J Public Health, 106, pp.686~688 (2016)
- Soyka M, "Treatment of benzodiazepine dependence", N Engl J Med, 376, pp.1147~1157 (2017)
- Airagnes G, "Prevalence of prescribed benzodiazepine longterm use in the French general population according to sociodemographic and clinical factors : findings from the CONSTANCES cohort", BMC Public Health, 19, pp.566~ (2019)
- Charlson F, "A systematic review of research examining benzodiazepine-related mortality", Pharmacoepidemiol Drug Saf, 18, pp.93~103 (2009)
- Kripke DF, "Hypnotics’ association with mortality or cancer : a matched cohort study", BMJ Open, 2, pp.e000850~ (2012)
- Weich S, "Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: retrospective cohort study", BMJ, 348, pp.g1996~ (2014)
- Kripke DF, "Mortality hazard associated with prescription hypnotics", Biol Psychiatry, 43, pp.687~693 (1998)
- Tiihonen J, "Polypharmacy with antipsychotics, antidepressants, or benzodiazepines and mortality in schizophrenia", Arch Gen Psychiatry, 69, pp.476~483 (2012)
- Belleville G, "Mortality hazard associated with anxiolytic and hypnotic drug use in the National Population Health Survey", Can J Psychiatry, 55, pp.558~567 (2010)
- Mallon L, "Is usage of hypnotics associated with mortality?", Sleep Med, 10, pp.279~286 (2009)
- Thorogood M, "Fatal myocardial infarction and use of psychotropic drugs in young women", Lancet, 340, pp.1067~1068 (1992)
- Patorno E, "Benzodiazepines and risk of all cause mortality in adults: cohort study", BMJ, 358, pp.j2941~ (2017)
- Lee J, "Cohort profile : The National Health Insurance Service-National Sample Cohort(NHIS-NSC), South Korea", Int J Epidemiol, 46, pp.e15~ (2017)
- Rosenbaum PR, "The central role of the propensity score in observational studies for causal effects", Biometrika, 70, pp.41~55 (1983)
- Fisher LD, "Time-dependent covariates in the Cox proportional-hazards regression model", Annu Rev Public Health, 20, pp.145~157 (1999)
- Palmaro A, "Benzodiazepines and risk of death : results from two large cohort studies in France and UK", Eur Neuropsychopharmacol, 25, pp.1566~1577 (2015)
- Fontanella CA, "Benzodiazepine use and risk of mortality among patients with schizophrenia : a retrospective longitudinal study", J Clin Psychiatry, 77, pp.661~667 (2016)
- Griffin CE 3rd, "Benzodiazepine pharmacology and central nervous system-mediated effects", Ochsner J, 13, pp.214~223 (2013)
- Lader M, "Benzodiazepines. A risk–benefit profile", CNS Drugs, 1, pp.377~387 (1994)
- Saarelainen L, "Risk of death associated with new benzodiazepine use among persons with Alzheimer disease : a matched cohort study", Int J Geriatr Psychiatry, 33, pp.583~590 (2018)
- 김도형, "Use of Hypnotics and Risk of Cancer: A Meta-Analysis of Observational Studies", Korean Journal of Family Medicine, 39(4), pp.211~218 (2018), 대한가정의학회
- Kim HB, "Use of benzodiazepine and risk of cancer : a meta-analysis of observational studies", Int J Cancer, 140, pp.513~525 (2017)
- Peng TR, "Hypnotics and risk of cancer : a meta-analysis of observational studies", Medicina (Kaunas), 56, pp.513~ (2020)
- Gisev N, "Mortality associated with benzodiazepines and benzodiazepine-related drugs among community-dwelling older people in Finland : a population-based retrospective cohort study", Can J Psychiatry, 56, pp.377~381 (2011)
- Jaussent I, "Hypnotics and mortality in an elderly general population : a 12-year prospective study", BMC Med, 11, pp.212~ (2013)
- Vinkers DJ, "Benzodiazepine use and risk of mortality in individuals aged 85 years or older", JAMA, 290, pp.2942~2943 (2003)
- Kurtz SP, "Benzodiazepine dependence among young adult participants in the club scene who use drugs", J Psychoactive Drugs, 49, pp.39~46 (2017)
- Maust DT, "Benzodiazepine use and misuse among adults in the United States", Psychiatr Serv, 70, pp.97~106 (2019)
- Calcaterra SL, "Trends in intentional abuse or misuse of benzodiazepines and opioid analgesics and the associated mortality reported to poison centers across the United States from 2000 to 2014", Clin Toxicol (Phila), 56, pp.1107~1114 (2018)
- Cato V, "Association between benzodiazepines and suicide risk : a matched case-control study", BMC Psychiatry, 19, pp.317~ (2019)