Mortality After Lower Extremity Fractures in Men With Spinal Cord Injury
Mortality After Lower Extremity Fractures in Men With Spinal Cord Injury
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DOI：
10.1002/jbmr.2050
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发表时间：
2014-02-01
影响因子：
6.2
通讯作者：
Weaver, Frances
中科院分区：
文献类型：
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作者：
Carbone, Laura D.;Chin, Amy S.;Weaver, Frances
在美国，有超过200，000名患有脊髓损伤（SCI）的男性面临下肢骨折的风险。SCI骨折后的死亡风险尚不清楚。这是一项以人群为基础的队列研究，研究对象为2002财年至2010财年在退伍军人事务部（VA）脊髓功能障碍登记处登记的所有创伤性SCI持续时间至少2年的男性退伍军人（平均年龄54.1岁;范围20.3 - 100.5岁），以确定下肢骨折与死亡率之间的相关性。确定长达5年的死亡率。下肢骨折发生率为2.14/100患者-年，至少有一处骨折的风险。在未校正的模型和根据人口统计学、SCI相关因素、医疗保健使用和合并症校正的模型中，下肢骨折事件与死亡率增加之间存在显著相关性（风险比[HR]，1.38; 95%置信区间[CI]，1.17 - 1.63; HR，1.36; 95% CI，1.15 - 1.61）。在完全性SCI中，下肢骨折后的死亡风险也增加（未校正模型：HR，1.46; 95% CI，1.13 - 1.89;校正模型：HR，1.32; 95% CI，1.02 - 1.71）。在完全校正的模型中，整个队列中老年男性（年龄50岁）和完全SCI患者（HR，3.13; 95%CI，2.19 - 4.45）的下肢骨折事件与死亡率增加的相关性显著高于年轻男性（年龄50岁）。
In the United States, there are over 200,000 men with spinal cord injuries (SCIs) who are at risk for lower limb fractures. The risk of mortality after fractures in SCI is unknown. This was a population-based, cohort study of all male veterans (mean age 54.1; range, 20.3-100.5 years) with a traumatic SCI of at least 2 years' duration enrolled in the Veterans Affairs (VA) Spinal Cord Dysfunction Registry from FY2002 to FY2010 to determine the association between lower extremity fractures and mortality. Mortality for up to 5 years was determined. The lower extremity fracture rate was 2.14 per 100 patient-years at risk for at least one fracture. In unadjusted models and in models adjusted for demographic, SCI-related factors, healthcare use, and comorbidities, there was a significant association between incident lower extremity fracture and increased mortality (hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.17-1.63; HR, 1.36; 95% CI, 1.15-1.61, respectively). In complete SCI, the hazard of death after lower extremity fracture was also increased (unadjusted model: HR, 1.46; 95% CI, 1.13-1.89; adjusted model: HR, 1.32; 95% CI, 1.02-1.71). In fully-adjusted models, the association of incident lower extremity fracture with increased mortality was substantially greater in older men (age 50 years) for the entire cohort (HR, 3.42; 95% CI, 2.75-4.25) and for those with complete SCI (HR, 3.13; 95% CI, 2.19-4.45), compared to younger men (age