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Best Practices for Management of Fractures in Spinal Cord Injuries and Disorders

脊髓损伤和疾病骨折管理的最佳实践

基本信息

批准号：
9293507
负责人：
LAURA D CARBONE
金额：
--
依托单位：
CHARLIE NORWOOD VA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-01 至 2020-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9293507
关键词：
Acute Acute Adverse event Adverse event Amputation Amputation Area Area Bone Density Bone Density Caring Caring Clinical Clinical Consensus Consensus Data Data Data Set Data Set Decision Making Decision Making Decubitus ulcer Decubitus ulcer Disease Disease Event Event Femoral Fractures Femoral Fractures Fracture Fracture Future Future Goals Goals Guidelines Guidelines Heterotopic Ossification Heterotopic Ossification Hospitals Hospitals Hour Hour Infection Infection Interview Interview Lead Lead Lesion Lesion Literature Literature Location Location Lower Extremity Lower Extremity Lower Extremity Fracture Lower Extremity Fracture Morbidity - disease rate Morbidity - disease rate Operative Surgical Procedures Operative Surgical Procedures Orthopedics Orthopedics Osteoporotic Osteoporotic Outcome Patient Care Patient Care Patients Patients Perception Perception Personal Communication Personal Communication Physicians Physicians Population Population Practice Management Practice Management Process Process Prospective Studies Prospective Studies Provider Provider Publishing Publishing Questionnaires Questionnaires Reporting Reporting Research Research Sampling Sampling Severities Severities Site Site Spinal cord injury Spinal cord injury Structure Structure Surgeon Surgeon Surgical Disarticulation Surgical Disarticulation Surveys Surveys Testing Testing Time Time Treatment outcome Treatment outcome Veterans Veterans Work Work administrative database administrative database adverse outcome adverse outcome base base bone loss bone loss care outcomes demographics demographics experience experience health care model health care model health care service utilization health care service utilization men men mortality mortality optimal treatments osteoporosis with pathological fracture osteoporosis with pathological fracture patient population patient population repaired repaired residence residence support tools support tools

项目摘要

Osteoporotic-related fractures are a serious problem for patients with Spinal Cord Injury (SCI). However, best management for acute care of these fractures including whether surgical vs. nonsurgical treatment should be done and the factors that influence this decision is not known. This point is well appreciate by providers, who have identified to SCI QUERI that research to establish best practices for treatment of fractures in patients with a SCI should be a priority area. Surgical treatment for lower extremity fractures is done more frequently than previously reported, with approximately 10-37% of these fractures now managed surgically. However, the factors that influence the choice of surgical vs. nonsurgical fracture treatments and outcomes following these therapies have not been described. In this proposal we will utilize administrative databases, semi-structured questionnaires and case scenarios, and convene an outstanding advisory panel to review this information and existing literature to start the process of understanding best management for osteoporotic fractures in SCI. We will include both patients and providers (orthopedic surgeons and PM&R physicians) in the surveys. This proposal is of direct, immediate potential clinical benefit to the expanding population of patients with SCI. It will provide invaluable information for providers to better be able to care for these patients when they sustain an osteoporotic fracture.

骨质疏松性骨折是脊髓损伤（SCI）患者的严重问题。然而，最好这些骨折的急性护理管理，包括是否应该手术与非手术治疗，这一决定已经完成，影响这一决定的因素尚不清楚。这一点得到了供应商的充分赞赏，他们我已经向SCI QUERI确定了研究，以建立治疗骨折患者的最佳实践， SCI应该是一个优先领域。下肢骨折的手术治疗比以前报道过，这些骨折中约有10-37%现在通过手术治疗。但影响手术与非手术骨折治疗选择的因素以及这些因素之后的结果尚未描述治疗方法。在本提案中，我们将利用半结构化的管理数据库，调查问卷和案例情景，并召集一个杰出的咨询小组审查这一信息，现有的文献，开始了解最佳的管理过程中，脊髓损伤。我们将在调查中包括患者和提供者（整形外科医生和PM&R医生）。这该提案对不断扩大的SCI患者群体具有直接、立即的潜在临床益处。它将为提供者提供宝贵的信息，以便能够更好地照顾这些患者，骨质疏松性骨折