title: Peripheral Arterial Disease and Spinal Cord Injury: A Retrospective Nationwide Cohort Study.
abstract: The aim of this study was to elucidate the relationship between spinal cord injury (SCI) and the risk of peripheral arterial disease (PAD) in a cohort study with a large representative sample.The National Health Insurance Database was used to select patients who were diagnosed from 2000 to 2010. Patients with a history of PAD were excluded. The SCI group comprised 42,673 patients diagnosed with SCI, and we enrolled 170,389 matched controls (non-SCI group). We used a Cox proportional hazards regression model to analyze the adjusted risk of PAD between the case and control patients.Patients with SCI exhibited a significantly higher risk (hazard ratio [HR] = 1.37; 95% confidence interval [CI] = 1.22-1.53) of PAD than patients without SCI. Patients with diabetes were at the highest risk of developing PAD (adjusted HR = 3.11, 95% CI = 2.80-3.44). Among patients without comorbidity, SCI patients exhibited a significantly higher risk of PAD than non-SCI patients. Furthermore, lumbar, sacral, or coccygeal spine, and multiple spine SCI were significantly associated with an increased risk of PAD (HR = 1.56, 95% CI = 1.33-1.84, HR = 2.11, 95% CI = 1.59-2.79, respectively).SCI is associated with an increased risk of PAD. Future studies should focus on modifying risk factors to reduce PAD risk among patients with SCI.
authors.affiliation: From the Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan (TWS); Department of Physical Medicine and Rehabilitation, China Medical University Hospital (TYC, PYY); Department of Orthopedic Surgery, Kuang Tien General Hospital (HJJ); Department of Nursing, Hungkuang University (HJJ); School of Medicine, China Medical University (PYY, CLL); Management Office for Health Data, China Medical University Hospital (CLL, FCS); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (FCS, CYH, CHK); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (CHK).
authors.forename: Ta-Wei
authors.initials: TW
authors.lastname: Su
authors.forename: Tzu-Yi
authors.initials: TY
authors.lastname: Chou
authors.forename: Herng-Jeng
authors.initials: HJ
authors.lastname: Jou
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Yang
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Chung-Y
authors.initials: CY
authors.lastname: Hsu
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology*