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
研究目的：旨在评估就诊于急诊科的儿童及青少年中，创伤前12个月内使用糖皮质激素（glucocorticoids）与创伤性骨折之间的关联。
研究方法：本研究为病例对照研究，于2015年4月至10月在某儿科急诊医院开展，纳入年龄3~14岁的躯体创伤患者，其中部分患者合并骨折，其余未发生骨折。本研究分析的数据来源于患者病历记录、体格检查结果及患者照护者的访谈资料。对比两组患者的12个月内糖皮质激素使用情况、人口统计学变量、体质量指数（body mass index, BMI）、乳制品摄入量、创伤严重程度、体力活动水平及家庭吸烟状况。
研究结果：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%既往使用过糖皮质激素，两组间未观察到统计学显著性差异。10~14岁年龄段、重度创伤及体力活动水平较高的患者在骨折组中更为常见。
研究结论：本研究未发现儿童及青少年既往使用糖皮质激素与骨折发生之间存在关联。10~14岁年龄段、重度创伤及体力活动水平较高与骨折风险升高显著相关。