The association of opioid use with incident lower extremity fractures in spinal cord injury Journal Article


Authors: Carbone, L D; Chin, A. S.; Lee, T. A.; Burns, S. P.; Svircevs, J. N.; Hoenig, H. M.; Akhigbe, T; Weaver, F M
Article Title: The association of opioid use with incident lower extremity fractures in spinal cord injury
Abstract: Objective To determine the association between opioid use and lower extremity fracture risk in men with spinal cord injury (SCI). Design Retrospective cohort study. Setting Veterans Affairs Healthcare System. Participants In total, 7447 male Veterans with a history of a traumatic SCI identified from the Veterans Affairs (VA) Spinal Cord Dysfunction Registry (SCD) from September 2002 through October 2007 and followed through October 2010. Outcome measures Incident lower extremity fractures by use of opioids. Results In individuals identified from the VA SCD Registry 2002-2007, opioid use was quite common, with approximately 70% of the cohort having received a prescription for an opioid. Overall, there were 892 incident lower extremity fractures over the time period of this study (597 fractures in the opioid users and 295 fractures in the non-opioid users). After adjusting for covariates, there was a statistically significant relationship between opioid use and increased risk for lower extremity fractures (hazard ratio 1.82 (95% confidence interval 1.59-2.09)). Shorter duration of use (6 months) and higher doses were positively related to fracture risk (P 0.0001). Conclusions Opioid use is quite common in SCI and is associated with an increased risk for lower extremity fractures. Careful attention to fracture prevention is warranted in patients with SCI, particularly upon initiation of an opioid prescription and when higher doses are used.
Keywords: Male; General Internal Medicine; Human; Analgesics, Opioid -- Adverse Effects; Fractures -- Risk Factors; Lower Extremity -- Injuries; Spinal Cord Injuries -- Complications; Age Factors; Analgesics, Opioid -- Administration and Dosage; Bone Density; Data Analysis; Disease Duration; Outcomes (Health Care); Patient Care; Pharmacy and Pharmacology; Rehabilitation -- Methods; Spinal Cord; Veterans
Journal Title: Journal of Spinal Cord Medicine
Volume: 36
Issue: 2
ISSN: 1079-0268
Publisher: Unknown  
Date Published: 2013
Start Page: 91
End Page: 96
Language: English
DOI/URL:
Notes: ID: 2012066312
LUC Authors
  1. Frances M Weaver
    53 Weaver
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