Best Practices for Management of Fractures in Spinal Cord Injuries and Disorders

脊髓损伤和疾病骨折管理的最佳实践

• 批准号: 10178106
• 负责人: LAURA D CARBONE
• 金额: --
• 依托单位: CHARLIE NORWOOD VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2020-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10178106
• 关键词: Acute; Adverse event; Amputation; Area; Bone Density; Caring; Clinical; Consensus; Data; Data Set; Decision Making; Disease; Event; Femoral Fractures; Fracture; Future; Goals; Guidelines; Heterotopic Ossification; Hospitals; Hour; Infection; Interview; Lead; Lesion; Literature; Location; Lower Extremity; Lower Extremity Fracture; Morbidity - disease rate; Operative Surgical Procedures; Orthopedics; Osteoporotic; Patient Care; Patients; Perception; Personal Communication; Physicians; Population; Practice Management; Process; Prospective Studies; Provider; Publishing; Questionnaires; Reporting; Research; Sampling; Severities; Site; Spinal cord injury; Structure; Surgeon; Surgical Disarticulation; Surveys; Testing; Time; Treatment outcome; Veterans; Work; acute care; administrative database; adverse outcome; base; bone loss; care outcomes; decubitus ulcer; demographics; experience; health care model; health care service utilization; men; mortality; optimal treatments; osteoporosis with pathological fracture; patient population; repaired; residence; support tools

Osteoporotic-related fractures are a serious problem for patients with Spinal Cord Injury (SCI). However, best management for acute care of these fractures including whether surgical vs. nonsurgical treatment should be done and the factors that influence this decision is not known. This point is well appreciate by providers, who have identified to SCI QUERI that research to establish best practices for treatment of fractures in patients with a SCI should be a priority area. Surgical treatment for lower extremity fractures is done more frequently than previously reported, with approximately 10-37% of these fractures now managed surgically. However, the factors that influence the choice of surgical vs. nonsurgical fracture treatments and outcomes following these therapies have not been described. In this proposal we will utilize administrative databases, semi-structured questionnaires and case scenarios, and convene an outstanding advisory panel to review this information and existing literature to start the process of understanding best management for osteoporotic fractures in SCI. We will include both patients and providers (orthopedic surgeons and PM&R physicians) in the surveys. This proposal is of direct, immediate potential clinical benefit to the expanding population of patients with SCI. It will provide invaluable information for providers to better be able to care for these patients when they sustain an osteoporotic fracture.

与骨质疏松相关的骨折是脊髓损伤患者（SCI）的严重问题。但是，最好 治疗这些骨折的急性护理，包括手术与非手术治疗是否应该是 完成和影响该决定的因素尚不清楚。这一点非常感谢提供者 已经确定了Sci Queri的研究，以建立治疗骨折的最佳实践 SCI应该是优先区域。下肢骨折的手术治疗要比 先前报道的，这些骨折中约有10-37％通过手术管理。但是， 影响手术选择与非手术骨折治疗和结果之后的因素 尚未描述疗法。在此提案中，我们将使用管理数据库，半结构 问卷和案例场景，并召集一个出色的咨询小组以查看此信息，并 现有文献开始理解科学骨质疏松性骨折的最佳管理过程。 我们将在调查中包括患者和提供者（骨科外科医生和PM＆R医生）。这 提案对不断扩大的SCI患者人群具有直接，直接的潜在临床益处。会 为提供者提供宝贵的信息，以便在这些患者维持这些患者时能够更好地照顾他们 骨质疏松骨折。