The epidemiology of fracture in patients with acute ischemic stroke in Korea

On behalf of the CRCS-K investigators

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article numbere164
JournalJournal of Korean medical science
Volume34
Issue number22
DOIs
Publication statusPublished - 2019 Jun 1

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Korea
Epidemiology
Stroke
Confidence Intervals
Incidence
Hip Fractures
National Health Programs
Osteoporosis
Spine
Registries
Databases

Keywords

  • Fracture
  • Incidence
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The epidemiology of fracture in patients with acute ischemic stroke in Korea. / On behalf of the CRCS-K investigators.

In: Journal of Korean medical science, Vol. 34, No. 22, e164, 01.06.2019.

Research output: Contribution to journalArticle

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title = "The epidemiology of fracture in patients with acute ischemic stroke in Korea",
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.",
keywords = "Fracture, Incidence, Stroke",
author = "{On behalf of the CRCS-K investigators} and Lee, {Kyung Bok} and Lee, {Jung Gon} and Kim, {Beom Joon} and Kim, {Jun Yup} and Lee, {Keon Joo} and Han, {Moon Ku} and Park, {Jong Moo} and Kyusik Kang and Cho, {Yong Jin} and Park, {Hong Kyun} and Hong, {Keun Sik} and Park, {Tai Hwan} and Lee, {Soo Joo} and Oh, {Mi Sun} and Yu, {Kyung Ho} and Lee, {Byung Chul} and Cha, {Jae Kwan} and Kim, {Dae Hyun} and Kim, {Joon Tae} and Jun Lee and Hong, {Jeong Ho} and Sohn, {Sung Il} and Kim, {Dong Eog} and Choi, {Jay Chol} and Yeo, {Min Ju} and Kim, {Wook Joo} and Chae, {Jae Eun} and Lee, {Ji Sung} and Juneyoung Lee and Bae, {Hee Joon}",
year = "2019",
month = "6",
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doi = "10.3346/jkms.2019.34.e164",
language = "English",
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T1 - The epidemiology of fracture in patients with acute ischemic stroke in Korea

AU - On behalf of the CRCS-K investigators

AU - Lee, Kyung Bok

AU - Lee, Jung Gon

AU - Kim, Beom Joon

AU - Kim, Jun Yup

AU - Lee, Keon Joo

AU - Han, Moon Ku

AU - Park, Jong Moo

AU - Kang, Kyusik

AU - Cho, Yong Jin

AU - Park, Hong Kyun

AU - Hong, Keun Sik

AU - Park, Tai Hwan

AU - Lee, Soo Joo

AU - Oh, Mi Sun

AU - Yu, Kyung Ho

AU - Lee, Byung Chul

AU - Cha, Jae Kwan

AU - Kim, Dae Hyun

AU - Kim, Joon Tae

AU - Lee, Jun

AU - Hong, Jeong Ho

AU - Sohn, Sung Il

AU - Kim, Dong Eog

AU - Choi, Jay Chol

AU - Yeo, Min Ju

AU - Kim, Wook Joo

AU - Chae, Jae Eun

AU - Lee, Ji Sung

AU - Lee, Juneyoung

AU - Bae, Hee Joon

PY - 2019/6/1

Y1 - 2019/6/1

N2 - 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.

AB - 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.

KW - Fracture

KW - Incidence

KW - Stroke

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DO - 10.3346/jkms.2019.34.e164

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JO - Journal of Korean Medical Science

JF - Journal of Korean Medical Science

SN - 1011-8934

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