Acute and long-term increase in fracture risk after hospitalization for stroke.
OBJECTIVE
The aims of this study were to determine the magnitude of the increase in fracture risk after hospitalization for stroke, and in particular to determine the time course of this risk.


METHODS
The records of the Swedish register of patients admitted during 1987-1996 were examined to identify all patients who were admitted to the hospital for stroke. Patients were followed for subsequent hospitalizations for hip and all fractures combined. We analyzed 16.3 million hospitalizations, from which 273 288 individuals with stroke were identified. A Poisson model was used to determine the absolute risk of subsequent fractures and the risk compared with that of the general population.


RESULTS
After hospitalization for stroke, there was a >7-fold increase in fracture risk, including that for hip fracture within the first year after hospitalization for stroke. Thereafter, fracture risk declined toward, but did not attain, the baseline risk except in men and women aged >/=80 years.


CONCLUSIONS
The high incidence of new fractures within the first year of hospitalization for stroke suggests that such patients should be preferentially targeted for treatment. It is possible that short courses of treatment at the time of stroke would provide important therapeutic dividends.
Center for Metabolic Bone Diseases (World Health Organization Collaborating Center), University of Sheffield Medical School (UK). w.j.pontefract@sheffield.ac.uk
J
J
Kanis
A
A
Oden
O
O
Johnell
D000208:Acute Disease; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology*; D006620:Hip Fractures / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D016016:Proportional Hazards Models; D012306:Risk; D018570:Risk Assessment / Q000706:statistics & numerical data; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology* / Q000628:therapy; D013548:Sweden / Q000453:epidemiology; D013995:Time