Morbidity following lower extremity fractures in men with spinal cord injury

Laura D Carbone, A. S. Chin, S. P. Burns, J. N. Svircev, H. Hoenig, M. Heggeness, F. Weaver

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

The Veterans Affairs Spinal Cord Dysfunction Registry from 2002 to 2007 was reviewed to determine whether men with spinal cord injury (SCI) and lower extremity fractures had an increased risk of complications compared to those without fractures. We determined that fractures are associated with significant consequences, particularly during the first month postfracture. Introduction: Despite increasing longevity, patients with SCI have a substantial number of illnesses and comorbid conditions. Lower extremity fractures are frequent events in these patients. However, whether these fractures are associated with any increased risk of complications in SCI is not certain. The purpose of this report was to determine the impact of lower extremity fractures on morbidities in men with SCI. Methods: A population-based, nested, case-control (1,027 cases and 1,027 propensity-matched controls) of men enrolled in the Veterans Affairs Spinal Cord Dysfunction Registry from fiscal years 2002 to 2007 was reviewed to determine whether lower extremity fractures were associated with an increased risk for complications. Results: In propensity score models matched for demographic (age, race) and SCI-related injury factors (level/completeness of SCI), Veterans Affairs-service connection status, and comorbidities, at 1 month following the fracture, there was an increased risk for respiratory infections, pressure ulcers, urinary tract infections, thromboembolic events, depression, and delirium (p ≤ 0.03 for all). Over 12 months, the only complication more common in fracture cases was pressure ulcers (p < 0.01), with an absolute difference of less than 2 % when compared to controls. There was no significant increased risk of cardiac arrhythmias at any time examined following fracture (≥0.12). Conclusions: Lower extremity fractures are associated with significant consequences in men with SCI during the first month postfracture, but they do not persist for a long term, except for pressure ulcers. Targeted interventions to prevent complications should be considered following lower extremity fractures in SCI, particularly in the first month following fracture.

Original languageEnglish (US)
Pages (from-to)2261-2267
Number of pages7
JournalOsteoporosis International
Volume24
Issue number8
DOIs
StatePublished - Aug 1 2013

Fingerprint

Spinal Cord Injuries
Lower Extremity
Morbidity
Pressure Ulcer
Veterans
Registries
Spinal Cord
Propensity Score
Delirium
Urinary Tract Infections
Respiratory Tract Infections
Comorbidity
Cardiac Arrhythmias
Demography
Depression
Wounds and Injuries
Population

Keywords

  • Fractures
  • Men
  • Morbidity
  • Pressure ulcers
  • Spinal cord injury

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Carbone, L. D., Chin, A. S., Burns, S. P., Svircev, J. N., Hoenig, H., Heggeness, M., & Weaver, F. (2013). Morbidity following lower extremity fractures in men with spinal cord injury. Osteoporosis International, 24(8), 2261-2267. https://doi.org/10.1007/s00198-013-2295-8

Morbidity following lower extremity fractures in men with spinal cord injury. / Carbone, Laura D; Chin, A. S.; Burns, S. P.; Svircev, J. N.; Hoenig, H.; Heggeness, M.; Weaver, F.

In: Osteoporosis International, Vol. 24, No. 8, 01.08.2013, p. 2261-2267.

Research output: Contribution to journalArticle

Carbone, LD, Chin, AS, Burns, SP, Svircev, JN, Hoenig, H, Heggeness, M & Weaver, F 2013, 'Morbidity following lower extremity fractures in men with spinal cord injury', Osteoporosis International, vol. 24, no. 8, pp. 2261-2267. https://doi.org/10.1007/s00198-013-2295-8
Carbone, Laura D ; Chin, A. S. ; Burns, S. P. ; Svircev, J. N. ; Hoenig, H. ; Heggeness, M. ; Weaver, F. / Morbidity following lower extremity fractures in men with spinal cord injury. In: Osteoporosis International. 2013 ; Vol. 24, No. 8. pp. 2261-2267.
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