IS THERE AN ASSOCIATION BETWEEN GLUCOCORTICOID USE AND FRACTURES? A COMPARATIVE STUDY IN A TRAUMA HOSPITAL

ABSTRACT Objective: To assess the association between traumatic fractures and glucocorticoids taken 12 months prior to a trauma, in children and adolescents seen at an emergency room. Methods: A case-control study was conducted from April to October 2015, at a pediatric emergency hospital with patients aged 3- to 14 years-old, who had suffered physical trauma. Some of the patients had a fracture and some did not. The data analyzed were obtained from medical records, physical examination of the patients, and interview with the patients’ caregivers. Glucocorticoid use in the past 12 months, demographic variables, body mass index, milk intake, trauma intensity, physical activity and smoking in the household were compared between the two patient groups. Results: A total of 104 patients with physical trauma were studied - 50 had a fracture and 54 did not. Of all the patients, 15.4% had previously used glucocorticoids, and there were no statistically significant differences between the groups. The age range of 10- to 14 years-old, severe trauma and physical activity were more prevalent among patients with a bone fracture. Conclusions: This study did not find an association between previous glucocorticoid use and the occurrence of fractures in children and adolescents. The age range of 10- to 14 years-old, severe trauma, and physical activity were associated with an increased risk for fractures.

摘要

目的：旨在评估急诊科就诊的儿童青少年群体中，创伤前12个月使用糖皮质激素（glucocorticoid）与外伤性骨折之间的关联。

方法：本研究于2015年4月至10月在某儿科急诊医院开展病例对照研究，纳入年龄为3至14岁、曾遭受躯体创伤的患者，其中部分患者合并骨折，其余未发生骨折。研究数据来源于病历记录、患者体格检查结果及患者看护者访谈。对两组患者的12个月内糖皮质激素使用情况、人口学特征、体质量指数、乳类摄入、创伤严重程度、体力活动及家庭吸烟状况进行对比分析。

结果：本研究共纳入104名躯体创伤患者，其中50名合并骨折，54名未发生骨折。所有受试者中15.4%曾使用糖皮质激素，两组间未观察到统计学显著性差异。10至14岁年龄段、严重创伤及体力活动在骨折患者中更为多见。

结论：本研究未发现儿童青少年既往糖皮质激素使用与骨折发生之间存在关联。10至14岁年龄段、严重创伤及体力活动与骨折风险升高相关。