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APHA Scientific Session and Event Listing

Ranjana Banerjea, MA, ABD¹, Miriam Maney, MS¹, Anjali Tiwari, MBBS, MS², Thomas Findley, MD, PhD², Leonard Pogach, MD, MBA², Frances Weaver, PhD³, and Usha Sambamoorthi, PhD². (1) Center for Health Care Knowledge and Management, VA New Jersey Health Care System, 385 Tremont Ave, East Orange, NJ 07018-1095, 973-676-1000, x2552, banerjea@njneuromed.org, (2) Center for Healthcare Knowledge Management, Department of Veterans Affairs, NJ Health Care System, 385 Tremont avenue, East Orange, NJ 07018, (3) Mdwest Ctr for health services & Policy Research (151H), VA hospital, Hines, IL 60141

BACKGROUND: Diabetes is a major risk factor for increased macrovascular complications in the general population. However, association between diabetes and macrovascular complications in patients with spinal cord injury (SCI), specifically the veteran SCI population, has not been studied. OBJECTIVE: This study compares the rates of macrovascular complications among veterans with SCI and diabetes to those with SCI and no diabetes. DESIGN: A retrospective cohort study using Veteran Health Administration (VHA) data for VHA clinic users with SCI. SCI was identified by using ICD-9-CM codes from inpatient files in fiscal year 1999. Macrovascular complications were identified in FY 2000, and consisted of congestive heart failure, ischemic heart disease, stroke and peripheral vascular diseases. Chi-square tests and logistic regressions were used to assess the association between diabetes and macrovascular complications in patients with SCI. PARTICIPANTS: Study population included 27,040 VHA clinic users (>18 years), with SCI. Among these SCI patients, 4,569 (16.9%) were classified as having diabetes. MAIN RESULTS: VHA users who had both SCI and diabetes were more likely to have macrovascular complications (24.6% vs 8.3%). After controlling for demographic, access to healthcare, and health status factors, SCI patients with diabetes were 2.5 times as likely as those without diabetes to have any macrovascular complications. CONCLUSIONS: Patients with SCI are at higher risk for diabetes and macrovascular conditions. This study points out to the need for greater multidisciplinary management and strategies to optimize the provision of both treatment and preventive healthcare services to the population with SCI.

Learning Objectives:

• Health care professionals will be able to increase awareness, recognize the need for greater intervention and prioritize health care management for those with Spinal Cord Injuries and diabetes.

Keywords: Diabetes, Disability

Presenting author's disclosure statement:

Not Answered

Handout (.ppt format, 217.5 kb)