Authors: L D Carbone A S Chin S P Burns J N Svircev H Hoenig M Heggeness F Weaver
Publish Date: 2013/02/08
Volume: 24, Issue: 8, Pages: 2261-2267
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 postfractureDespite 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 SCIA populationbased nested case–control 1027 cases and 1027 propensitymatched 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 complicationsIn propensity score models matched for demographic age race and SCIrelated injury factors level/completeness of SCI Veterans Affairsservice 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 ≤ 003 for all Over 12 months the only complication more common in fracture cases was pressure ulcers p 001 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 ≥012Lower 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
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