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(Stroke. 2001;32:702.)
© 2001 American Heart Association, Inc.

Original Contributions

Acute and Long-Term Increase in Fracture Risk After Hospitalization for Stroke

John Kanis, MD; Anders Oden, PhD Olof Johnell, MD

From the Center for Metabolic Bone Diseases (World Health Organization Collaborating Center), University of Sheffield Medical School (UK) (J.K.); Consulting Statistician, Romelanda, Sweden (A.O.); and Department of Orthopedics, Malmö General Hospital (Sweden) (O.J.).

Correspondence to Professor J.A. Kanis, Center for Metabolic Bone Diseases (WHO Collaborating Center), University of Sheffield Medical School, Beech Hill Rd, Sheffield S10 2RX, UK. E-mail w.j.pontefract{at}sheffield.ac.uk

Background and Purpose—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.

Key Words: fractures, spontaneous • hip fractures • prospective studies • stroke

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