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Spinal Cord Injury and Alcohol Use are Risk Factors for Osteoporosis Hospitalization


Spinal cord injury (SCI) is associated with severe osteoporosis, increasing the risk of low-impact fractures that occur in the absence of trauma. The treatment of long bone (i.e., humerus, femur) fractures often results in lengthy hospitalizations for individuals with SCI, but factors that contribute to the risk of hospitalization are unknown. This study assessed the health of 315 Veterans > 1 year after SCI to assess whether sociodemographic and health-related factors (i.e., comorbid illness) assessed at baseline prospectively predict hospitalization related to low-impact fractures. Using VA data, investigators also reviewed fracture-related treatment and complications. Veterans in this study were recruited from the VA Boston SCI Service between 10/94 and 12/02.

Findings show that hospitalization for low-impact fractures was more common in motor complete SCI (no motor function below the neurological level of injury) and was associated with greater alcohol use after injury. Age, education, weight, smoking, hypertension, heart disease, diabetes, asthma, and COPD were not significant predictors of fracture-related hospitalizations. Although hospital admission for osteoporotic fractures accounted for only 2.6% of the hospital admissions for this cohort, the median length of stay was seven-fold greater for fracture admissions compared to non-fracture admissions. Hospitalization for fractures also was associated with frequent medical complications that sometimes required discharge to a second facility for additional care. Surprisingly, osteoporosis diagnosis, prevention, and management were not included in the treatment plans for any of the Veterans hospitalized with fractures. These findings suggest that future studies should address prevention and treatment of bone loss among Veterans with motor complete SCI.

PubMed Logo Morse L, Battaglino R, Stolzmann K, Hallet L, Waddimba A, Gagnon D, Lazzari A, and Garchick E. Osteoporotic fractures and hospitalization risk in chronic spinal cord injury. Osteoporosis International March 2009;20(3):385-392.

This study was partly funded by HSR&D. Drs. Stolzmann, Hallet, Waddimba, Gagnon, Lazzari, and Garshick are part of the VA Boston Healthcare System.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.