Keele Research Repository

<h4>Background: </h4> The prevention of self-harm is an international public health priority, It is vital to identify at-risk populations, particularly as self-harm is a risk factor for suicide. This study aims to examine the risk of self-harm in people with vertebral fractures <h4>Methods: </h4> Retrospective cohort study using data from the Clinical Practice Research Datalink. Patients with vertebral fracture were identified and matched to patients without fracture by age and gender. Incident self-harm was defined by medical record codes following vertebral fracture. Overall incidence rates (per 10,000 person-years (PY)) were reported. Cox regression analysis determined risk (hazard ratios (HR), 95% confidence interval (CI)) of self-harm compared to the matched unexposed cohort. Initial crude analysis was subsequently adjusted and stratified by age and gender. <h4>Results: </h4> The number of cases of vertebral fracture was 16,293, with a matched unexposed cohort of the same size. Patients were predominantly female (70.1%), mean age was 74 years. Overall incidence of self-harm in the cohort with vertebral fracture was 12.2 (10.1, 14.8) /10,000 PY. There was an initial crude association between vertebral fracture and self-harm, which remained after adjustment (HR 2.4 (95%CI 1.5, 3.6).Greatest risk of self-harm was found in those with vertebral fractures who were younger (3.2(1.8, 5.7)) and male (3.9(1.8, 8.5)). <h4>Conclusions: </h4> Primary care patients with vertebral fracture are at increased risk of self-harm compared to people without these fractures. Younger, male patients appear to be at greatest risk of self-harm. Clinicians need to be aware of the potential for self-harm in this patient group.