• Ta-Wei Su, Tzu-Yi Chou, Herng-Jeng Jou, Pei-Yu Yang, Cheng-Li Lin, Fung-Chang Sung, Chung-Y Hsu, and Chia-Hung Kao.
• 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).
• Medicine (Baltimore). 2015 Oct 1; 94 (41): e1655.

AbstractThe 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.

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