The Epidemiology of Fracture in Patients with Acute Ischemic Stroke in Korea
10.3346/jkms.2019.34.e164
- Author:
Kyung Bok LEE
1
;
Jung Gon LEE
;
Beom Joon KIM
;
Jun Yup KIM
;
Keon Joo LEE
;
Moon Ku HAN
;
Jong Moo PARK
;
Kyusik KANG
;
Yong Jin CHO
;
Hong Kyun PARK
;
Keun Sik HONG
;
Tai Hwan PARK
;
Soo Joo LEE
;
Mi Sun OH
;
Kyung Ho YU
;
Byung Chul LEE
;
Jae Kwan CHA
;
Dae Hyun KIM
;
Joon Tae KIM
;
Jun LEE
;
Jeong Ho HONG
;
Sung Il SOHN
;
Dong Eog KIM
;
Jay Chol CHOI
;
Min Ju YEO
;
Wook Joo KIM
;
Jae Eun CHAE
;
Ji Sung LEE
;
Juneyoung LEE
;
Hee Joon BAE
;
Author Information
1. Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
- Publication Type:Multicenter Study
- Keywords:
Stroke;
Fracture;
Incidence
- MeSH:
Accidental Falls;
Asian Continental Ancestry Group;
Epidemiology;
Female;
Hip Fractures;
Humans;
Incidence;
Korea;
National Health Programs;
Osteoporosis;
Prospective Studies;
Risk Factors;
Spine;
Stroke
- From:Journal of Korean Medical Science
2019;34(22):e164-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Patients who survive an acute phase of stroke are at risk of falls and fractures afterwards. However, it is largely unknown how frequent fractures occur in the Asian stroke population. METHODS: Patients with acute (< 7 days) ischemic stroke who were hospitalized between January 2011 and November 2013 were identified from a prospective multicenter stroke registry in Korea, and were linked to the National Health Insurance Service claim database. The incidences of fractures were investigated during the first 4 years after index stroke. The cumulative incidence functions (CIFs) were estimated by the Gray's test for competing risk data. Fine and Gray model for competing risk data was applied for exploring risk factors of post-stroke fractures. RESULTS: Among a total of 11,522 patients, 1,616 fracture events were identified: 712 spine fractures, 397 hip fractures and 714 other fractures. The CIFs of any fractures were 2.63% at 6 months, 4.43% at 1 year, 8.09% at 2 years and 13.00% at 4 years. Those of spine/hip fractures were 1.11%/0.61%, 1.88%/1.03%, 3.28%/1.86% and 5.79%/3.15%, respectively. Age by a 10-year increment (hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.17–1.30), women (HR, 1.74; 95% CI, 1.54–1.97), previous fracture (HR, 1.72; 95% CI, 1.54–1.92) and osteoporosis (HR, 1.44; 95% CI, 1.27–1.63) were independent risk factors of post-stroke fracture. CONCLUSION: The CIFs of fractures are about 8% at 2 years and 13% at 4 years after acute ischemic stroke in Korea. Older age, women, pre-stroke fracture and osteoporosis raised the risk of post-stroke fractures.
