Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil

Objective. The aim of this study is to examine the application value of systematic nursing interventions combined with continuity of care in cases with a spinal fracture complicated with a spinal cord injury and its effect on recovery and satisfaction. Methods. We identified ninety cases with a spinal fracture complicated with a spinal cord injury who were admitted to local hospital from May 2019 to May 2021 as research subjects and assigned them into an experimental group (systematic nursing combined with continuity of care, n = 45) and a control group (conventional nursing, n = 45) according to their admission order. The level of life of all groups between intervention was evaluated with reference to the Generic Quality of Life Inventory-74 (GQOLI-74) Rating Scale. The Hospital Anxiety and Depression (HAD) scale was used to assess the emotional status of patients before and after intervention. The complication rates, nursing outcomes, nursing satisfaction, and rehabilitation outcomes of all cases were calculated. Results. The GQOLI-74 score of the experimental group was higher than that of another group ( P < 0.05 ). Lower HAD scores of experimental group were observed than that of another group ( P < 0.05 ). The experimental group obtained remarkably higher nursing effective rates and higher nursing satisfaction than another group ( P < 0.05 ). Rehabilitation outcome of the experimental group outperformed that another group ( P < 0.05 ). Conclusion. The use of systematic nursing intervention combined with continuity of care for cases with spinal fracture complicated with a spinal cord injury can enhance the nursing effect, effectively relieve cases’ psychological pressure, improve patients’ level of life and nursing satisfaction, and contribute to the maintenance of a good nurse-patient relationship, which merits clinical promotion.

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“…erefore, e ective care measures are required for patients with spinal fractures with a spinal cord injury [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Systematic Nursing Interventions Combined with Continuity of Care in Patients with a Spinal Fracture Complicated with a Spinal Cord Injury and Its Effect on Recovery and Satisfaction

Xia

Wang

2022

Evidence-Based Complementary and Alternative Medicine

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“…Fracture rates vary in the SCI population between 2.14 and 3.2 fractures per 100 patient-years ( 4 , 6 – 8 ). Women with SCI over age 50 are at higher risk of fracture than younger women, or men of any age (hazard ratio: 1.54, 95% CI: 1.12–2.11) ( 9 ). Fractures commonly occur after a fall from standing or from seated height onto a flexed knee, or from rotational stress on the distal lower extremity during routine activities of daily living ( 10 – 15 ).…”

Section: Introductionmentioning

confidence: 99%

“…Fractures among PLEX, whether managed operatively or conservatively, result in increased secondary health complications including respiratory infections, pressure ulcers, urinary tract infections, delirium, and venous thromboembolic events ( 5 , 6 ). Additional complications of fracture include: autonomic dysreflexia, pressure injuries, pin site or joint infection, spasticity ( 16 ), and shoulder pain with depression ( 9 , 17 ). Carbone et al have reported that in a study on a cohort of 12,389 male veterans with traumatic SCI for at least 2 years, lower extremity fractures were associated with increased 5-year mortality.…”

Section: Introductionmentioning

confidence: 99%

Bone health education in individuals with spinal cord injury or disease—the Bare Bones Podcast Series: plan it, produce it, post it!

Craven,

Kaiser,

Blencowe

et al. 2024

Front. Rehabil. Sci.

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IntroductionThe Consortium for Spinal Cord Medicine's inaugural Clinical Practice Guideline for Bone Health and Osteoporosis Management for Individuals with Spinal Cord Injury or Disease (CSCM-CPG) was published in 2022 for a clinician audience. The aim of this project was to develop a podcast series to ensure people with lived experience with Spinal Cord Injury or Disease (PLEX) understand the CSCM-CPG content and know how to act to reduce their fracture risk.MethodsThe “Bare Bones Podcast Series” consists of nine episodes; one related to each CSCM-CPG chapter. The podcast content and the questions asked in each podcast were co-developed by PLEX partners (PLEX-P) and the project team. Two PLEX-P acted as co-hosts for the series. The invited speaker(s) were CSCM-CPG expert panel members who participated in an informal dialogue with the hosts. Each podcast closes with a specific action a listener can do to advance their bone health. The related Educational Action Planning Tool (EAT) handouts contain text and infographic information specific to each podcast episode and include key concepts and a specific actionable take-home message. Local PLEX reviewers (PLEX-R) were invited to review podcast episodes and EATs and provide their feedback through focus group participation or one-on-one (1:1) interviews. The project team revised the podcast episodes and the EATs based on feedback from the PLEX-R prior to releasing them online.ResultsNine podcast episodes and related EATs were designed and created collaboratively with 3 PLEX-P, 22 PLEX-R, 11 CSCM-CPG expert panel members, and the project team. The episodes were titled: “Introduction to the Bare Bones of Bone Health”; “Fracture 101”; “Blood Tests—a Window into You”; “I See Your Skeleton”; “Vitamin D for all, Calcium for Some”; “Get Moving and Loading”; “Pills or Poisons & Atomic Habits”; “Snap and Crack”; and “Directions for Research”. The Bare Bones Podcast Series was shared through the project website.ConclusionsThe podcasts will aid PLEX and their family caregivers to advocate for ongoing bone health assessments and to promote an ongoing dialogue with care team members regarding how to prevent fractures and fracture-related morbidity and mortality.

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“…Estimates of the number of Americans living with spinal cord injury (SCI) range from 300,000 to 1.2 million 1 , 2 . Lower extremity fractures are common occurrences for persons with a chronic SCI, with 1 report suggesting that 25% to 46% of these individuals will sustain a lower extremity fracture during their lifetime 3 . Other investigators have reported that more than half of persons with an SCI will suffer a low-impact or osteoporotic fracture at some point following the injury 4 .…”

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confidence: 99%

Acute Lower Extremity Fracture Management in Chronic Spinal Cord Injury

et al. 2022

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Background:Our objective was to develop a clinical practice guideline (CPG) for the treatment of acute lower extremity fractures in persons with a chronic spinal cord injury (SCI).Methods:Information from a previous systematic review that addressed lower extremity fracture care in persons with an SCI as well as information from interviews of physical and occupational therapists, searches of the literature, and expert opinion were used to develop this CPG. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to determine the quality of evidence and the strength of the recommendations. An overall GRADE quality rating was applied to the evidence.Conclusions:Individuals with a chronic SCI who sustain an acute lower extremity fracture should be provided with education regarding the risks and benefits of operative and nonoperative management, and shared decision-making for acute fracture management should be used. Nonoperative management historically has been the default preference; however, with the advent of greater patient independence, improved surgical techniques, and advanced therapeutics and rehabilitation, increased use of surgical management should be considered. Physical therapists, kinesiotherapists, and/or occupational therapists should assess equipment needs, skills training, and caregiver assistance due to changes in mobility resulting from a lower extremity fracture. Therapists should be involved in fracture management as soon as possible following fracture identification. Pressure injuries, compartment syndrome, heterotopic ossification, nonunion, malunion, thromboembolism, pain, and autonomic dysreflexia are fracture-related complications that clinicians caring for patients who have an SCI and a lower extremity fracture may encounter. Strategies for their treatment are discussed. The underlying goal is to return the patient as closely as possible to their pre-fracture functional level with operative or nonoperative management.

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Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil

Cited by 14 publications

References 26 publications

Systematic Nursing Interventions Combined with Continuity of Care in Patients with a Spinal Fracture Complicated with a Spinal Cord Injury and Its Effect on Recovery and Satisfaction

Systematic Nursing Interventions Combined with Continuity of Care in Patients with a Spinal Fracture Complicated with a Spinal Cord Injury and Its Effect on Recovery and Satisfaction

Bone health education in individuals with spinal cord injury or disease—the Bare Bones Podcast Series: plan it, produce it, post it!

Acute Lower Extremity Fracture Management in Chronic Spinal Cord Injury

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