The association of opioid use with incident lower extremity fractures in spinal cord injury

Laura D. Carbone, Amy S. Chin, Todd A. Lee, Stephen P. Burns, Jelena N. Svircev, Helen M. Hoenig, Titilola Akhigbe, Frances M. Weaver

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Objective: To determine the association between opioid use and lower extremity fracture risk in men with spinal cord injury (SCI). Design: Retrospective cohort study. Setting: Veterans Affairs Healthcare System. Participants: In total, 7447 male Veterans with a history of a traumatic SCI identified from the Veterans Affairs (VA) Spinal Cord Dysfunction Registry (SCD) from September 2002 through October 2007 and followed through October 2010. Outcome measures: Incident lower extremity fractures by use of opioids. Results: In individuals identified from the VA SCD Registry 2002-2007, opioid use was quite common, with approximately 70% of the cohort having received a prescription for an opioid. Overall, there were 892 incident lower extremity fractures over the time period of this study (597 fractures in the opioid users and 295 fractures in the non-opioid users). After adjusting for covariates, there was a statistically significant relationship between opioid use and increased risk for lower extremity fractures (hazard ratio 1.82 (95% confidence interval 1.59-2.09)). Shorter duration of use (<6 months) and higher doses were positively related to fracture risk (P < 0.0001). Conclusions: Opioid use is quite common in SCI and is associated with an increased risk for lower extremity fractures. Careful attention to fracture prevention is warranted in patients with SCI, particularly upon initiation of an opioid prescription and when higher doses are used.

Original languageEnglish (US)
Pages (from-to)91-96
Number of pages6
JournalJournal of Spinal Cord Medicine
Volume36
Issue number2
DOIs
Publication statusPublished - Mar 1 2013
Externally publishedYes

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Keywords

  • Bone mineral density
  • Fractures
  • Opioids
  • Osteoporosis
  • Rehabilitation
  • Spinal cord injuries
  • Veterans

ASJC Scopus subject areas

  • Clinical Neurology

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