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01-03-2009 | Original Article

Osteoporotic fractures and hospitalization risk in chronic spinal cord injury

Authors: L. R. Morse, R. A. Battaglino, K. L. Stolzmann, L. D. Hallett, A. Waddimba, D. Gagnon, A. A. Lazzari, E. Garshick

Published in: Osteoporosis International | Issue 3/2009

Abstract

Summary

Osteoporosis is a well acknowledged complication of spinal cord injury. We report that motor complete spinal cord injury and post-injury alcohol consumption are risk factors for hospitalization for fracture treatment. The clinical assessment did not include osteoporosis diagnosis and treatment considerations, indicating a need for improved clinical protocols.

Introduction

Treatment of osteoporotic long bone fractures often results in lengthy hospitalizations for individuals with spinal cord injury. Clinical features and factors that contribute to hospitalization risk have not previously been described.

Methods

Three hundred and fifteen veterans ≥ 1 year after spinal cord injury completed a health questionnaire and underwent clinical exam at study entry. Multivariate Cox regression accounting for repeated events was used to assess longitudinal predictors of fracture-related hospitalizations in Veterans Affairs Medical Centers 1996–2003.

Results

One thousand four hundred and eighty-seven hospital admissions occurred among 315 participants, and 39 hospitalizations (2.6%) were for fracture treatment. Median length of stay was 35 days. Fracture-related complications occurred in 53%. Independent risk factors for admission were motor complete versus motor incomplete spinal cord injury (hazard ratio = 3.73, 95% CI = 1.46–10.50). There was a significant linear trend in risk with greater alcohol consumption after injury. Record review indicated that evaluation for osteoporosis was not obtained during these admissions.

Conclusions

Assessed prospectively, hospitalization in Veterans Affairs Medical Centers for low-impact fractures is more common in motor complete spinal cord injury and is associated with greater alcohol use after injury. Osteoporosis diagnosis and treatment considerations were not part of a clinical assessment, indicating the need for improved protocols that might prevent low-impact fractures and related admissions.

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Title: Osteoporotic fractures and hospitalization risk in chronic spinal cord injury
Authors: L. R. Morse
R. A. Battaglino
K. L. Stolzmann
L. D. Hallett
A. Waddimba
D. Gagnon
A. A. Lazzari
E. Garshick
Publication date: 01-03-2009
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 3/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-008-0671-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Osteoporotic fractures and hospitalization risk in chronic spinal cord injury

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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