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Cited by 58Pharmaceutical Practices and Patient OutcomesSleep and related disordersSubstance Abuse Treatment and Outcomes

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

Lai, Ming-May, Lin, Cheng-Chieh, Lin, Che-Chen, Liu, Chiu-Shong, Li, Tsai-Chung, Kao, Chia-Hung·2014·Mayo Clinic Proceedings
DOI 10.1016/j.mayocp.2014.01.021
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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.

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Authors
Lai, M.-M., Lin, C.-C., Lin, C.-C., Liu, C.-S., Li, T.-C., & Kao, C.-H.
Affiliations
  • China Medical University (TW)
  • Asia University (TW)
Corresponding author
Kao, Chia-Hung
ORCID
Venue
Mayo Clinic Proceedings
Publisher
Elsevier BV
Published
2014-05
Volume
89
Issue
5
Pages
589-594
ISSN
0025-6196 (ISSN-L)
DOI
10.1016/j.mayocp.2014.01.021
OpenAlex
W2044419673
Cited by
58
References
14
Citations by year
2026: 1 · 2025: 2 · 2023: 3 · 2022: 1 · 2021: 5 · 2020: 7 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 10 · 2015: 8 · 2014: 3 · 2013: 1
FWCI
4.42
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Mayo Clinic Proceedings (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Health Research Institutes
Topics
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
zolpidem, sedative-hypnotic drugs, severe trauma, traumatic brain injury, fracture, hospitalization, long-term drug use, dose-response relationship, young adults, drug safety
MeSH terms
Accidental Falls, Accidents, Traffic, Zolpidem, Adolescent, Adult, Aged, Aged, 80 and over, Female, Craniocerebral Trauma, Humans, Hypnotics and Sedatives, Male, Middle Aged, Pyridines, Time Factors, Cohort Studies, Incidence, Proportional Hazards Models, Age Distribution, Fractures, Bone, Young Adult

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