Abstract
Objective
To determine the association between thiazide use and lower extremity fractures in
patients who are men with a spinal cord injury (SCI).
Design
Cohort study from fiscal years 2002 to 2007.
Setting
Medical centers.
Participants
Men (N=6969) with an SCI from the Veterans Affairs (VA) Spinal Cord Dysfunction (SCD)
Registry, including 1433 users of thiazides and 5536 nonusers of thiazides.
Intervention
Thiazide use versus nonuse.
Main Outcome Measure
Incident lower extremity fractures.
Results
Among the men, 21% in the VA SCD Registry (fiscal years 2002–2007) included in these
analyses used thiazide diuretics. There were 832 incident lower extremity fractures
over the time period of this study: 110 fractures (7.7%) in 1433 thiazide users and
722 fractures (13%) in 5536 nonusers 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: hazard ratio (HR)=.75;
95% confidence interval (CI), .59–.94; adjusted: HR=.74; 95% CI, .58–.95).
Conclusions
Thiazide use is common in men with SCI and is associated with a decreased likelihood
for lower extremity fractures.
Keywords
List of abbreviations:
BZD (benzodiazepine), CI (confidence interval), FY (fiscal year), HR (hazard ratio), ICD-9 (International Statistical Classification of Diseases, 9th revision), SAS (Statistical Analysis System), SCD (Spinal Cord Dysfunction), SCI (spinal cord injury), SSRI (selective serotonin reuptake inhibitor), VA (Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 30, 2013
Footnotes
Supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development (grant no. IIR 08-033).
The contents do not represent the views of the Department of Veterans Affairs or the United States Government.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
