{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:15:24Z","timestamp":1790882124440,"version":"4.1.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2013,7,22]],"date-time":"2013-07-22T00:00:00Z","timestamp":1374451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,2,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2003<\/jats:title>\n                  <jats:p>In the United States, there are over 200,000 men with spinal cord injuries (SCIs) who are at risk for lower limb fractures. The risk of mortality after fractures in SCI is unknown. This was a population-based, cohort study of all male veterans (mean age 54.1; range, 20.3\u2013100.5 years) with a traumatic SCI of at least 2 years' duration enrolled in the Veterans Affairs (VA) Spinal Cord Dysfunction Registry from FY2002 to FY2010 to determine the association between lower extremity fractures and mortality. Mortality for up to 5 years was determined. The lower extremity fracture rate was 2.14 per 100 patient-years at risk for at least one fracture. In unadjusted models and in models adjusted for demographic, SCI-related factors, healthcare use, and comorbidities, there was a significant association between incident lower extremity fracture and increased mortality (hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.17\u20131.63; HR, 1.36; 95% CI, 1.15\u20131.61, respectively). In complete SCI, the hazard of death after lower extremity fracture was also increased (unadjusted model: HR, 1.46; 95% CI, 1.13\u20131.89; adjusted model: HR, 1.32; 95% CI, 1.02\u20131.71). In fully-adjusted models, the association of incident lower extremity fracture with increased mortality was substantially greater in older men (age \u226550 years) for the entire cohort (HR, 3.42; 95% CI, 2.75\u20134.25) and for those with complete SCI (HR, 3.13; 95% CI, 2.19\u20134.45), compared to younger men (age &amp;lt;50 years) (entire cohort: HR, 1.42; 95% CI, 0.94\u20132.14; complete SCI: HR, 1.71; 95% CI, 0.98\u20133.01). Every additional point in the Charlson comorbidity index was associated with a 10% increase in the hazard of death in models involving the entire cohort (HR, 1.11; 95% CI, 1.09\u20131.13) and also in models limited to men with complete SCI (HR, 1.10; 95% CI, 1.06\u20131.15). These data support the concept that both the fracture itself and underlying comorbidities are drivers of death in men with SCI. \u00a9 2014 American Society for Bone and Mineral Research.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/jbmr.2050","type":"journal-article","created":{"date-parts":[[2013,7,22]],"date-time":"2013-07-22T06:17:23Z","timestamp":1374473843000},"page":"432-439","source":"Crossref","is-referenced-by-count":69,"title":["Mortality After Lower Extremity Fractures in Men With Spinal Cord Injury"],"prefix":"10.1093","volume":"29","author":[{"given":"Laura D","family":"Carbone","sequence":"first","affiliation":[{"name":"Department of MedicineUniversity of Tennessee Health Science CenterMemphisTNUSA"},{"name":"Veterans Affairs Medical CenterMemphisTNUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy S","family":"Chin","sequence":"additional","affiliation":[{"name":"Edward J. HinesJr. Veterans Affairs (VA) HospitalHinesILUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation MedicineUniversity of WashingtonSeattleWAUSA"},{"name":"Veterans Affairs (VA) Puget Sound Health Care SystemSeattleWAUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena N","family":"Svircev","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation MedicineUniversity of WashingtonSeattleWAUSA"},{"name":"Veterans Affairs (VA) Puget Sound Health Care SystemSeattleWAUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Hoenig","sequence":"additional","affiliation":[{"name":"Durham Veterans Affairs Medical Center (VAMC)DurhamNCUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Heggeness","sequence":"additional","affiliation":[{"name":"Department of OrthopedicsBaylor UniversityHoustonTXUSA"},{"name":"Veterans Affairs Medical CenterHoustonTXUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Bailey","sequence":"additional","affiliation":[{"name":"Edward J. 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