This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To determine the risk of fractures after stroke.
Methods: Using the Ontario Stroke Registry, we identified a population-based sample of consecutive patients seen in the emergency department or hospitalized with stroke (n = 23,751) or TIA (n = 11,240) at any of 11 stroke centers in Ontario, Canada, and discharged alive between July 1, 2003, and March 31, 2012. We compared the risk of low-trauma fractures in patients with stroke vs those with TIA using propensity score methods to adjust for differences in baseline factors. Secondary analyses compared fracture risk poststroke with that in age-/sex-matched controls without stroke or TIA (n = 23,751) identified from the Ontario Registered Persons Database.
Results: The 2-year rate of fracture was 5.7% in those with stroke compared to 4.8% in those with TIA (adjusted cause-specific hazard ratio [aHR] for those with stroke vs TIA 1.32; 95% confidence interval [CI] 1.19–1.46) and 4.1% in age-/sex-matched controls (aHR for those with stroke vs controls 1.47; 95% CI 1.35–1.60). In the cohort with stroke, factors associated with fractures were older age, female sex, moderate stroke severity, prior fractures or falls, and preexisting osteoporosis, rheumatoid arthritis, hyperparathyroidism, and atrial fibrillation.
Conclusions: Stroke is associated with an increased risk of low-trauma fractures. Individuals with stroke and additional risk factors for fractures may benefit from targeted screening for low bone mineral density and initiation of treatment for fracture prevention.
GLOSSARY
- aHR=
- adjusted hazard ratio;
- CI=
- confidence interval;
- ICES=
- Institute for Clinical Evaluative Sciences
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received May 6, 2016.
- Accepted in final form September 22, 2016.
- © 2016 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hastening the Diagnosis of Amyotrophic Lateral Sclerosis
Dr. Brian Callaghan and Dr. Kellen Quigg