Abstract
Study design
Retrospective study
Objectives
To describe the epidemiological and clinical profile in a retrospective chart review of individuals with spinal cord injury (SCI) and osteoporosis-related fractures.
Setting
A Brazilian rehabilitation hospital.
Methods
This is a retrospective chart review that included 325 individuals with SCI and osteoporosis-related fractures who were admitted to a Brazilian rehabilitation hospital between January 1997 and December 2017.
Results
Overall, 52% were males with a mean (SD) age of 44.8 (±16.7) years at the time of first fracture. Overall, 82% had paraplegia and 56% had a thoracic neurological level. The mean (SD) time between SCI and fracture was 9.7 (±9.3) years. In 59% of cases the immediate cause of the fracture was a fall. The locations of the fractures were distal femur (27%), proximal femur (27%), and tibia and/or distal fibula (28%). The fractures occurred mostly at home (63%). Complications occurred in 19% of individuals and 25% reported worse performance in activities of daily living and 29% a deterioration in ambulation after they had recovered from the fracture. A second fracture was described in 15% of individuals, and five individuals had a third fracture. The mean (SD) level of 25 hydroxyvitamin D [25 (OH) D] was 25.6 (±15.2) ng/ml, and only 11 individuals (3%) underwent dual energy X-ray absorptiometry (DEXA), and 26 individuals (8%) were treated with antiresorptive drugs after fracture.
Conclusion
Little is done to prevent fractures in individuals with SCI and understanding the clinical and epidemiological profiles will help identify risk factors and establish prevention programs and appropriate treatment.
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Data availability
Anonymized data will be shared by request from any qualified investigator.
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Acknowledgements
The authors would like to thank Luiz Sérgio Vaz for statistical analysis.
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The Research Ethics Committees of the Sarah Network of Rehabilitation Hospitals approved this study number: 66396817.7.0000.0022
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Champs, A.P.S., Maia, G.A.G., Oliveira, F.G. et al. Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil. Spinal Cord 58, 484–489 (2020). https://doi.org/10.1038/s41393-019-0387-9
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DOI: https://doi.org/10.1038/s41393-019-0387-9
