TY - JOUR
T1 - Long-term fracture risk following ischemic stroke
T2 - A population-based study
AU - Melton, L. J.
AU - Brown, R. D.
AU - Achenbach, S. J.
AU - O'Fallon, W. M.
AU - Whisnant, J. P.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2001
Y1 - 2001
N2 - 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.
AB - 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.
KW - Epidemiology
KW - Hip fracture
KW - Osteoporosis
KW - Stroke
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U2 - 10.1007/s001980170028
DO - 10.1007/s001980170028
M3 - Article
C2 - 11804025
AN - SCOPUS:0035667918
SN - 0937-941X
VL - 12
SP - 980
EP - 986
JO - Osteoporosis International
JF - Osteoporosis International
IS - 11
ER -