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Stroke Research and Treatment
Volume 2013 (2013), Article ID 641943, 17 pages
http://dx.doi.org/10.1155/2013/641943
Research Article

Poststroke Hip Fracture: Prevalence, Clinical Characteristics, Mineral-Bone Metabolism, Outcomes, and Gaps in Prevention

1Department of Geriatric Medicine, The Canberra Hospital, P.O. Box 11, Canberra, Woden, ACT 2606, Australia
2Australian National University Medical School, P.O. Box 11, Canberra, Woden, ACT 2606, Australia
3Department of Orthopaedic Surgery, The Canberra Hospital, P.O. Box 11, Canberra, Woden, ACT 2606, Australia

Received 6 June 2013; Revised 6 August 2013; Accepted 20 August 2013

Academic Editor: David S. Liebeskind

Copyright © 2013 Alexander Fisher et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To assess the prevalence, clinical and laboratory characteristics, and short-term outcomes of poststroke hip fracture (HF). Methods. A cross-sectional study of 761 consecutive patients aged ≥60 years ( years; 75% females) with osteoporotic HF. Results. The prevalence of poststroke HF was 13.1% occurring on average 2.4 years after the stroke. The poststroke group compared to the rest of the cohort had a higher proportion of women, subjects with dementia, history of TIA, hypertension, coronary artery disease, secondary hyperparathyroidism, higher serum vitamin B12 levels (>350 pmol/L), walking aid users, and living in residential care facilities. The majority of poststroke HF patients had vitamin D insufficiency (68%) and excess bone resorption (90%). This group had a 3-fold higher incidence of postoperative myocardial injury and need for institutionalisation. In multivariate analysis, independent indicators of poststroke HF were female sex (OR 3.6), history of TIA (OR 5.2), dementia (OR 4.1), hypertension (OR 3.2), use of walking aid (OR 2.5), and higher vitamin B12 level (OR 2.3). Only 15% of poststroke patients received antiosteoporotic therapy prior to HF. Conclusions. Approximately one in seven HFs occurs in older stroke survivors and are associated with poorer outcomes. Early implementation of fracture prevention strategies is needed.