Fracture Risk Among Stroke Survivors According to Poststroke Disability Status and Stroke Type.
Stroke
; 55(6): 1498-1506, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38686561
ABSTRACT
BACKGROUND:
Stroke survivors face physical and cognitive challenges, leading to an increased dependency and a higher fall risk. We aimed to investigate the impact of poststroke disability and stroke type on fracture risk at various sites compared with matched controls.METHODS:
This retrospective cohort study used data from the Korean National Health Insurance System database (2010-2018), including patients with stroke and 11 matched controls. Stroke survivors were grouped based on the presence and severity of their poststroke disability and stroke type. The primary outcome was a newly diagnosed fracture, analyzed by Cox proportional hazard regression analyses adjusting for potential confounders.RESULTS:
Among 223â 358 stroke survivors (mean age, 64.8±10.9 years; 61.2% men), 16â 344 fractures occurred during a mean follow-up of 3.7±2.5 years. In matched controls (n=322â 161; mean age, 65.4±11.2 years; 61.3% men), 20â 398 fractures were identified. Stroke survivors had increased overall fracture risk compared with matched controls (adjusted hazard ratio [aHR], 1.40 [95% CI, 1.37-1.43]). Specifically, hip fracture risk was even greater in stroke survivors (incidence rate per 1000 person-years, 4.7 [95% CI, 4.5-4.8]; aHR, 2.42 [95% CI, 2.30-2.55]) than controls (incidence rate, 2.2 [95% CI, 2.1-2.3]). The risk of vertebral fractures (aHR, 1.29 [95% CI, 1.25-1.34]) and other fractures (aHR, 1.19 [95% CI, 1.15-1.23]) was also higher than that of the control group. Hip fracture risk was the highest among stroke survivors with severe poststroke disability (aHR, 4.82 [95% CI, 4.28-5.42]), although vertebral or other fracture risk was the highest among those with mild poststroke disability. No significant difference in fracture risk was found between hemorrhagic and ischemic stroke survivors when stratified by disability status.CONCLUSIONS:
Our findings showed increased subsequent fracture risk among stroke survivors, particularly those with poststroke disability and for hip fracture. Bone health assessment and treatment should be emphasized as an essential part of stroke management.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Acidente Vascular Cerebral
Limite:
Aged
/
Female
/
Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Stroke
Ano de publicação:
2024
Tipo de documento:
Article