Long-term fracture risk following ischemic stroke

A population-based study

L. J. Melton, Robert D Jr. Brown, S. J. Achenbach, W. M. O'Fallon, J. P. Whisnant

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The overall risk of fracture following stroke has not been well quantified. We addressed this issue in a population-based retrospective cohort study among the 387 Rochester, Minnesota residents who survived for 90 days following their first cerebral infarction during the 10-year period, 1960-69. Cases were matched by age and sex to controls from the general population of Rochester, and subsequent fractures were assessed through review of each subject's complete (inpatient and outpatient) medical records in the community. With comparable follow-up, the 128 fractures observed among cases were little more than the 118 seen among controls, and the cumulative incidence of any fracture after 25 years was not significantly different (71% versus 66%; p=0.464). Using stratified Cox analysis, there was no increase in the risk of fractures generally (hazard ratio (HR), 1.1; 95% CI, 0.8-1.6) or hip fractures specifically (HR, 1.1; 95% CI, 0.6-2.1) compared with controls. Among the stroke patients with hemiparesis or hemiplegia, the majority of fractures occurred on the impaired side. In a multivariate analysis, fracture risk increased with age (HR per 10 years, 1.6; 95% CI, 1.4-2.0), with hospitalization at onset of stroke (HR, 2.0; 95% CI, 1.3-3.2) and with moderate functional impairment (HR, 1.6; 95% CI, 1.02-2.5) but not severe disability (HR, 0.8; 95% CI, 0.4-1.6). No other characteristic of the stroke or its treatment was an independent predictor of overall fracture risk. Patients and their caretakers need to be aware of the risk of fracture from falls, particularly when moderate impairment permits the patient to be independently mobile.

Original languageEnglish (US)
Pages (from-to)980-986
Number of pages7
JournalOsteoporosis International
Volume12
Issue number11
DOIs
StatePublished - 2001

Fingerprint

Stroke
Population
Hemiplegia
Cerebral Infarction
Hip Fractures
Paresis
Medical Records
Inpatients
Hospitalization
Cohort Studies
Outpatients
Multivariate Analysis
Retrospective Studies
Incidence
Therapeutics

Keywords

  • Epidemiology
  • Hip fracture
  • Osteoporosis
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Long-term fracture risk following ischemic stroke : A population-based study. / Melton, L. J.; Brown, Robert D Jr.; Achenbach, S. J.; O'Fallon, W. M.; Whisnant, J. P.

In: Osteoporosis International, Vol. 12, No. 11, 2001, p. 980-986.

Research output: Contribution to journalArticle

Melton, L. J. ; Brown, Robert D Jr. ; Achenbach, S. J. ; O'Fallon, W. M. ; Whisnant, J. P. / Long-term fracture risk following ischemic stroke : A population-based study. In: Osteoporosis International. 2001 ; Vol. 12, No. 11. pp. 980-986.
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