Abstract: |
OBJECTIVES: To determine the association between thiazide use and lower extremity fractures in male patients with a Spinal Cord Injury (SCI). DESIGN: Cohort Study from Fiscal Year (FY) 2002-2007. SETTING: Veterans Affairs (VA) Medical Centers. PARTICIPANTS: 6,969 men with SCI from the VA SCD (Spinal Cord Dysfunction) Registry including 1,433 users of thiazides and 5,536 nonusers of thiazides. INTERVENTIONS: Thiazide use vs. nonuse. MAIN OUTCOME MEASURE: Incident lower extremity fractures. RESULTS: 21% of men in the VA SCD Registry (FY2002-FY2007) included in these analyses used thiazide diuretics. There were 832 incident lower extremity fractures over the time period of this study: 110/1433 (7.7%) in thiazide users and 722/5536 (13.0%) in non- users of thiazides. In unadjusted and adjusted models alike, thiazide use was associated with at least a one-quarter risk reduction in lower extremity fracture at any given point in time (unadjusted: HR 0.75, 95% CI 0.59-0.94; adjusted: HR 0.74, 95% CI 0.58-0.95). CONCLUSIONS: Thiazide use is common in men with SCI and is associated with a decreased likelihood for lower extremity fractures. |