Using Risk Scores to Estimate Lower Extremity Fragility Fracture Risk among Individuals with Chronic Spinal Cord Injury: A Preliminary Model

Top Spinal Cord Inj Rehabil, 2023 · DOI: 10.46292/sci23-00063S · Published: January 1, 2023

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

Individuals with motor complete SCI experience significant bone mineral density loss, increasing their risk of lower extremity fragility fractures. Current tools for estimating fracture risk aren't valid for those with SCI, lacking SCI-specific risk factors. This study aims to develop a risk score to estimate 5-year fragility fracture risk among individuals living with chronic SCI (cSCI).

Study Duration

2 years

Participants

90 adults with traumatic cSCI

Evidence Level

Not specified

Key Findings

1
A simple model was identified to estimate 5-year fracture risk among patients with cSCI based on their total score.
2
The most potent risk factors for fractures include prior fracture, parental osteoporosis, opioid use, motor complete injury, and years post injury.
3
Using CART analysis, the probability of imminent fracture in 2 years among patients with a history of fracture and more than 9 years post injury was 65%.

Research Summary

The study developed SCI-FX, a preliminary risk score to estimate 5-year lower extremity fragility fracture risk among patients living with chronic spinal cord injury (cSCI). The model incorporates factors like prior fragility fracture, years post-injury, motor complete injury, parental osteoporosis, and opioid use to calculate a risk score. The CART analysis identified prior fragility fracture and years post injury as key factors, showing a 65% fracture probability within 2 years for those with a fracture history and more than 9 years post-injury.

Practical Implications

Clinical Decision-Making

The SCI-FX tool can assist clinicians in identifying patients at high risk of fracture, enabling timely assessments and early interventions.

Intervention Strategies

Early identification of fracture risk can prompt the implementation of nutraceutical, drug, or rehabilitation interventions to improve bone mass and reduce fracture risk.

Future Research

Further model elaboration and validation with larger datasets are required before routine clinical implementation of this fracture risk prediction model.

Using Risk Scores to Estimate Lower Extremity Fragility Fracture Risk among Individuals with Chronic Spinal Cord Injury: A Preliminary Model

Simple Explanation

Key Findings

Research Summary

Practical Implications

Clinical Decision-Making

Intervention Strategies

Future Research

Study Limitations

Your Feedback

Was this summary helpful?

Using Risk Scores to Estimate Lower Extremity Fragility Fracture Risk among Individuals with Chronic Spinal Cord Injury: A Preliminary Model

Simple Explanation

Key Findings

Research Summary

Practical Implications

Clinical Decision-Making

Intervention Strategies

Future Research

Study Limitations

Your Feedback

Was this summary helpful?