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Journal of Korean Medical Science, 2019. 34(22), e164-, DOI: https://doi.org/10.3346/jkms.2019.34.e164
The Epidemiology of Fracture in Patients with Acute Ischemic Stroke in Korea
Kyung Bok Lee, 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 and on behalf of the CRCS-K investigators
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.
- DOI: https://doi.org/10.3346/jkms.2019.34.e164
- ISBN or ISSN: 1598-6357
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.