The Interaction Effect Between Previous Stroke and Hip Fracture on Postoperative Mortality: A Nationwide Cohort Study

Hjelholt, Thomas Johannesson; Johnsen, Søren Paaske; Brynningsen, Peter Krogh; Pedersen, Alma B

doi:10.2147/clep.s361507

Cited by 9 publications

(2 citation statements)

References 38 publications

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“…In comparison of the relatively healthy cluster, Cluster 1 and 2 in the Hong Kong cohort (and Cluster 1 in the UK cohort) were associated with an increased risk of 180-day mortality and MACE. Previous population-based cohort studies showed evidence of an association between a history of cardiovascular disease and increased mortality risk in patients with hip fracture 18,19 . A Danish study showed that a history of CVEs and cardiovascular biomarkers were associated with mortality within the 30-day period after hip fracture, with heart failure demonstrating the strongest association with mortality when compared to other CVEs 18 .…”

Section: Discussionmentioning

confidence: 99%

Unveiling unique clinical phenotypes of hip fracture patients and the temporal association with cardiovascular events

Hsu,

Zhang,

Sing

et al. 2024

Nat Commun

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Cardiovascular events are the leading cause of death among hip fracture patients. This study aims to identify subphenotypes of hip fracture patients and investigate their association with incident cardiovascular events, all-cause mortality, and health service utilisation in Hong Kong and the United Kingdom populations. By the latent class analysis, we show three distinct clusters in the Hong Kong cohort (n = 78,417): Cluster 1 has cerebrovascular and hypertensive diseases, hyperlipidemia, and diabetes; Cluster 2 has congestive heart failure; Cluster 3 consists of relatively healthy patients. Compared to Cluster 3, higher risks of major adverse cardiovascular events are observed in Cluster 1 (hazard ratio 1.97, 95% CI 1.83 to 2.12) and Cluster 2 (hazard ratio 4.06, 95% CI 3.78 to 4.35). Clusters 1 and 2 are also associated with a higher risk of mortality, more unplanned accident and emergency visits and longer hospital stays. Self-controlled case series analysis shows a significantly elevated risk of major adverse cardiovascular events within 60 days post-hip fracture. Similar associations are observed in the United Kingdom cohort (n = 27,948). Pre-existing heart failure is identified as a unique subphenotype associated with poor prognosis after hip fractures.

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Section: Discussionmentioning

confidence: 99%

Unveiling unique clinical phenotypes of hip fracture patients and the temporal association with cardiovascular events

Hsu,

Zhang,

Sing

et al. 2024

Nat Commun

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show abstract

“…Once fractures happen in the post-stroke period, they can interfere with rehabilitation, delay functional recovery, and even lead to more complications ( 12 , 13 ). One study also showed an excess in 30-day mortality in patients with stroke combined with hip fracture ( 14 ). Factors associated with post-stroke fractures include falls ( 15 ), stroke severity, and pre-stroke osteoporosis ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Utilization of screening and treatment for osteoporosis among stroke survivors

Hsu

Sung²,

Yang³

et al. 2022

Front. Endocrinol.

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BackgroundStroke survivors are prone to osteoporosis and fractures. However, bone mineral density (BMD) testing and osteoporosis treatment were underutilized in patients with recent stroke. We aimed to examine whether stroke has an impact on the utilization of BMD testing and osteoporosis treatment as well as the determinants of their utilization in stroke patients using nationwide population-based data in Taiwan.MethodsWe identified patients aged 55 years and older who were hospitalized for hemorrhagic or ischemic stroke as the stroke cohort, and age- and sex-matched patients hospitalized for reasons other than stroke, fracture, or fall as the non-stroke cohort. We used the Fine-Gray sub-distribution hazard competing risk regression model to determine the predictors for BMD testing and osteoporosis treatment.ResultsA total of 32997 stroke patients and 32997 age- and sex-matched controls comprised the stroke and non-stroke cohorts, respectively. BMD testing and osteoporosis treatment were performed in 1.0% and 5.2% of the stroke patients, respectively, within one year after hospitalization while these measures were performed in 0.8% and 4.7% of the controls. Stroke patients were more likely to receive BMD testing (adjusted hazard ratio [HR] 1.33; 95% confidence interval [CI] 1.11–1.58) and osteoporosis treatment (adjusted HR 1.19; 95% CI 1.11–1.29). Female sex, osteoporosis, prior BMD testing, and low-trauma fractures after stroke increased the likelihood of using BMD testing and osteoporosis treatment whereas greater stroke severity reduced the likelihood of receiving both measures.ConclusionsBoth BMD testing and osteoporosis treatment were underutilized among stroke survivors even though they had a higher chance of receiving both measures than non-stroke patients.

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Response to Letter to the Editor on “Chronic Phase Survival Rate in Stroke Patients With Severe Functional Limitations According to the Frequency of Rehabilitation Treatment”

Park

Kim

2023

Archives of Physical Medicine and Rehabilitation

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The Interaction Effect Between Previous Stroke and Hip Fracture on Postoperative Mortality: A Nationwide Cohort Study

Cited by 9 publications

References 38 publications

Unveiling unique clinical phenotypes of hip fracture patients and the temporal association with cardiovascular events

Unveiling unique clinical phenotypes of hip fracture patients and the temporal association with cardiovascular events

Utilization of screening and treatment for osteoporosis among stroke survivors

Response to Letter to the Editor on “Chronic Phase Survival Rate in Stroke Patients With Severe Functional Limitations According to the Frequency of Rehabilitation Treatment”

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