Fracture Risk Increases After Stroke or Transient Ischemic Attack and Is Associated With Reduced Quality of Life-Reference-Cited by-同舟云学术

Fracture Risk Increases After Stroke or Transient Ischemic Attack and Is Associated With Reduced Quality of Life

Published:2023-10 Issue:10 Volume:54 Page:2593-2601
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Dalli Lachlan L.¹^ORCID,Borschmann Karen²³^ORCID,Cooke Shae⁴^ORCID,Kilkenny Monique F.¹²^ORCID,Andrew Nadine E.⁵⁶^ORCID,Scott David¹⁷^ORCID,Ebeling Peter R.¹,Lannin Natasha A.⁸⁹^ORCID,Grimley Rohan¹¹⁰,Sundararajan Vijaya¹¹,Katzenellenbogen Judith M.¹²^ORCID,Cadilhac Dominique A.¹²^ORCID,Anderson Craig,Donnan Geoffrey,Levi Christopher,Thrift Amanda,Middleton Sandy,Faux Steven,Denisenko Sonia,Dewey Helen,Godecke Erin,Katzenellenbogen Judy,Lalor Erin,Lee Andrew,Longworth Mark,Cadigan Greg,Dilworth Cindy,Price Chris,Hill Kelvin,Page Matthew,Egan Jen,Grabsch Brenda,Kung Francis,Moss Karen,Street Steven,Tod Emma,Gibbs Adele,Purvis Tara,Reyneke Megan,

Affiliation:

1. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia (L.L.D., M.F.K., D.S., P.R.E., R.G., D.A.C.).

2. Stroke Division, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia (K.B., M.F.K., D.A.C.).

3. Allied Health Department, St Vincent’s Hospital, Melbourne, VIC, Australia (K.B.).

4. Eastern Health, Box Hill, VIC, Australia (S.C.).

5. Peninsula Clinical School, Central Clinical School, Monash University, Frankston, VIC, Australia (N.E.A.).

6. National Centre for Healthy Ageing, Frankston, VIC, Australia (N.E.A.).

7. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (D.S.).

8. Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia (N.A.L.).

9. Alfred Health, Melbourne, VIC, Australia (N.A.L.).

10. Sunshine Coast Clinical School, School of Medicine, Griffith University, Birtinya, QLD, Australia (R.G.).

11. Department of Medicine, St Vincent’s Hospital, Melbourne Medical School, University of Melbourne, VIC, Australia (V.S.).

12. School of Population and Global Health, The University of Western Australia, Perth, Australia (J.M.K.).

Abstract

BACKGROUND: Fractures are a serious consequence following stroke, but it is unclear how these events influence health-related quality of life (HRQoL). We aimed to compare annualized rates of fractures before and after stroke or transient ischemic attack (TIA), identify associated factors, and examine the relationship with HRQoL after stroke/TIA. METHODS: Retrospective cohort study using data from the Australian Stroke Clinical Registry (2009–2013) linked with hospital administrative and mortality data. Rates of fractures were assessed in the 1-year period before and after stroke/TIA. Negative binomial regression, with censoring at death, was used to identify factors associated with fractures after stroke/TIA. Respondents provided HRQoL data once between 90 and 180 days after stroke/TIA using the EuroQoL 5-dimensional 3-level instrument. Adjusted logistic regression was used to assess differences in HRQoL at 90 to 180 days by previous fracture. RESULTS: Among 13 594 adult survivors of stroke/TIA (49.7% aged ≥75 years, 45.5% female, 47.9% unable to walk on admission), 618 fractures occurred in the year before stroke/TIA (45 fractures per 1000 person-years) compared with 888 fractures in the year after stroke/TIA (74 fractures per 1000 person-years). This represented a relative increase of 63% (95% CI, 47%–80%). Factors associated with poststroke fractures included being female (incidence rate ratio [IRR], 1.34 [95% CI, 1.05–1.72]), increased age (per 10-year increase, IRR, 1.35 [95% CI, 1.21–1.50]), history of prior fracture(s; IRR, 2.56 [95% CI, 1.77–3.70]), and higher Charlson Comorbidity Scores (per 1-point increase, IRR, 1.18 [95% CI, 1.10–1.27]). Receipt of stroke unit care was associated with fewer poststroke fractures (IRR, 0.67 [95% CI, 0.49–0.93]). HRQoL at 90 to 180 days was worse among patients with prior fracture across the domains of mobility, self-care, usual activities, and pain/discomfort. CONCLUSIONS: Fracture risk increases substantially after stroke/TIA, and a history of these events is associated with poorer HRQoL at 90 to 180 days after stroke/TIA.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference43 articles.

1. Long-Term Fracture Risk Following Ischemic Stroke: A Population-Based Study

2. Fractures after stroke—A Danish register‐based study of 106 001 patients

3. The Epidemiology of Fracture in Patients with Acute Ischemic Stroke in Korea

4. Hip fracture after first-ever stroke: a population-based study

5. Fractures After Stroke

Cited by 1 articles. 订阅此论文施引文献订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献

1. Osteoporosis and fracture risk assessment in adults with ischaemic stroke;Osteoporosis International;2024-05-04