Adding injury to insult

Fracture risk after stroke in veterans

Heather E. Whitson*, Carl F. Pieper, Linda Sanders, Ronnie D. Horner, Pamela W. Duncan, Kenneth W. Lyles

*Corresponding author for this work

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

OBJECTIVES: To determine fracture risk in U.S. stroke patients and identify patient characteristics that predict highest fracture risk in two complementary cohorts. DESIGN: Secondary analyses of two prospective cohorts. SETTING: Veterans Affairs (VA) Medical Centers. PARTICIPANTS: The VA Acute Stroke (VASt) cohort includes 1,073 veterans admitted to nine VA hospitals for stroke between April 1995 and March 1997. The Integrated Stroke Outcomes Database (ISOD) includes 6,578 veterans who received inpatient rehabilitation for stroke at 121 VA facilities during fiscal years 2001 and 2002. MEASUREMENTS: Fractures detected using International Classification of Diseases, 9th Revision, codes in the VA computerized patient record system; baseline patient characteristics and stroke features; Functional Independence Measures scores in ISOD. RESULTS: Estimated 2-year fracture rates after stroke in the VASt and ISOD cohorts were 6.1% and 4.7%, respectively. Longer hospitalizations for stroke (P = .06) and new motor or sensory impairment (P = .09) showed trends toward greater risk in the VASt cohort. Female sex (P < .001), cognitive impairment (P = .01), and nonblackrace (P = .04) were associated with higher fracture risk in the ISOD. Intermediate functional impairment conferred higher fracture risk than mild or severe functional impairment. CONCLUSION: Veterans who suffer a stroke are at high risk of subsequent fracture, which can lead to further disability. Women, nonblacks, and those with intermediate functional impairment were at particularly high risk of fracture. Future study should investigate therapies to decrease fracture risk in stroke patients.

Original languageEnglish
Pages (from-to)1082-1088
Number of pages7
JournalJournal of the American Geriatrics Society
Volume54
Issue number7
DOIs
Publication statusPublished - Jul 2006
Externally publishedYes

Keywords

  • Comorbidity
  • Fracture
  • Osteoporosis
  • Stroke
  • Veterans

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    Whitson, H. E., Pieper, C. F., Sanders, L., Horner, R. D., Duncan, P. W., & Lyles, K. W. (2006). Adding injury to insult: Fracture risk after stroke in veterans. Journal of the American Geriatrics Society, 54(7), 1082-1088. https://doi.org/10.1111/j.1532-5415.2006.00769.x