Previous studies have demonstrated a high rate of death by suicide among patients with fractures. This study evaluated the associations between fracture and the risk of suicide.

The Taiwan National Health Insurance Research Database contains information covering more than 99% of Taiwan′s residents. From this database were identified all individuals 40 years of age or over with a suicide recorded as the cause of death between the years 2000 and 2011. All records identifying diagnoses of fractures and osteoporosis treated medically were reviewed. Covariates included gender, age, marital status, education, morbidity, osteoporosis, fractures, psychological comorbidity and income.

From the database were identified 34，794 patients who had died by suicide, who were then matched with 139，176 controls. Those with fractures exhibited a higher risk of suicide (adjusted odds ratio 1.48), including all fracture sites except the wrist. Fractures of the pelvis (adjusted odds ratio 2.04), spine (adjusted odds ratio 1.53), and femoral shaft (adjusted odds ratio 1.47) had a relatively higher risk than other sites. A diagnosis of osteoporosis was not associated with an increased risk of suicide.

This Taiwanese population study found that fractures are associated with an increased risk of suicide, especially hip and spine fractures.