Hospitalized burn injury risk associated with benzodiazepines and Z‐drugs in elders: A population‐based case‐control study

Objective To examine the association between benzodiazepines (BZDs) and Z‐drugs treatment and risk of burn injury in elders. Methods We designed a nested case‐control study. All subjects were aged 65 and older and enrolled in the National Health Insurance program in Taiwan, 2003 to 2012; 813 cases were identified with burn injury for the first time in their inpatient claims, and they were individually matched to 4879 controls based on age, gender, and index year. Benzodiazepines and Z‐drugs usage (doses, duration, half‐life) and the other covariates including comorbidities, health care utilization, and psychotropic medications used in the 365 days before index events were examined. Results A significant increased risk of burn injury hospitalization in elders was observed among current Z‐drugs users compared with nonusers (adjusted odds ratio [AOR] = 1.59, 95% confidence interval [CI] [1.23, 2.07]). BZDs at high (AOR = 1.81, 95% CI [1.12, 2.94] and medium dosage (AOR = 1.53, 95% CI [1.15, 2.04] and Z‐drugs at medium dosage (AOR = 1.60, 95% CI [1.20, 2.12]) were all significantly increased the burn‐related injury requiring hospitalization. Polypharmacy of anxiolytic and hypnotic BZDs, long‐ and short‐acting BZDs, and more than one BZD with or without Z‐drugs also increased the risk. Conclusions BZDs and Z‐drugs prescriptions in elders may be associated with increased risk of burn injury hospitalization. When prescribing BZDs and Z‐drugs, clinicians should exercise caution with the elderly to minimize risks.