Abstract

Abstract Background Inflammatory Bowel Disease (IBD) patients have been reported to have a higher frequency of femur fracture than healthy controls. Based on the data femur fractures in IBD patients, not many studies analyzing this correlation have been reported various risk factors, including corticosteroid therapy. Aim of this study was to demonstrate the prevalence of femur fracture in IBD patients with long-term corticosteroids. Methods The National Healthcare Insurance Service (NHIS) database of IBD patients between 2008-2018 was used for this cohort study. We collected the data of ICD-10 code, sex, age, comorbidities, corticosteroid use and IBD-related medications. The sex- and 10-year age matched non-IBD reference population was extracted during the same study period at a matching ratio of 1:3. Results From 2008 to 2018, 33,778 patients with IBD and 101,265 patients in the reference population were followed up for a median 5.0 years. The result showed that the use of corticosteroid more than 1year increased the risk of femur fracture of both Ulcerative Colitis and Crohn's Disease patient ((HR 2.83; 95% CI 1.37-5.84; P<0.01 and HR 2.62; 95% CI 1.00-6.86; p<0.05), respectively. Also, long term use of corticosteroid increased the severity of femur fracture (HR 0.62; 95% CI 0.43-0.90; p<0.05). Conclusion Femur fractures in patients with IBD patients are generally associated with results in hospitalization and related with significant morbidity and mortality. As use of corticosteroid and its duration contributed to femur fracture risk include its severity, prevention of fracture and careful corticosteroid therapy strategy should be considered.

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