Abstract
Background and Purpose: Fall and fracture risk increases after stroke. Little is known about the prognostic significance of previous falls and fractures after stroke. This study aimed to examine whether having a history of either is associated with mortality after stroke.
Methods: Using the prospectively collected stroke register data, between 20032015, we analysed the above relationship. Eight sex specific Models were analysed, incrementally adjusting for: age, type of stroke, Oxfordshire Community Stroke Project classification, previous comorbidities, frailty depicted by prestroke modified Rankin score (mRS) and acute illness parameters. Logistic regression was used for in hospital and 30 day mortality; and Cox Proportional Hazard Models were employed for longer term outcomes of mortality.
Results: A total of 10,477 patients with stroke (86.1% ischaemic) were included in the analysis. The mean age (SD) was 77.7±11.9 years; 52.2% were women. 8.6% of men (N=430) and 20.2% of women (N=1105) had a history of falls; 3.8% (N=189) of men and 12.9% of women (N=706) had a history of both falls and fractures. Of the outcomes examined, a history of falls alone was associated with increased in hospital and 30 day mortality in women; OR 1.33 (95%CI:1.031.71) and OR 1.34 (95%CI:1.031.73) respectively, in the fully adjusted Models. Cox Proportional Hazard Models for longer term outcomes and combined history of falls and fractures showed no significant results.
Conclusions: Falls history is an important factor for acute stroke mortality in women. A previous history of falls may therefore be an important factor to consider in short term stroke prognosis, particularly in women.
Methods: Using the prospectively collected stroke register data, between 20032015, we analysed the above relationship. Eight sex specific Models were analysed, incrementally adjusting for: age, type of stroke, Oxfordshire Community Stroke Project classification, previous comorbidities, frailty depicted by prestroke modified Rankin score (mRS) and acute illness parameters. Logistic regression was used for in hospital and 30 day mortality; and Cox Proportional Hazard Models were employed for longer term outcomes of mortality.
Results: A total of 10,477 patients with stroke (86.1% ischaemic) were included in the analysis. The mean age (SD) was 77.7±11.9 years; 52.2% were women. 8.6% of men (N=430) and 20.2% of women (N=1105) had a history of falls; 3.8% (N=189) of men and 12.9% of women (N=706) had a history of both falls and fractures. Of the outcomes examined, a history of falls alone was associated with increased in hospital and 30 day mortality in women; OR 1.33 (95%CI:1.031.71) and OR 1.34 (95%CI:1.031.73) respectively, in the fully adjusted Models. Cox Proportional Hazard Models for longer term outcomes and combined history of falls and fractures showed no significant results.
Conclusions: Falls history is an important factor for acute stroke mortality in women. A previous history of falls may therefore be an important factor to consider in short term stroke prognosis, particularly in women.
Original language | English |
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Pages (from-to) | 411-421 |
Number of pages | 11 |
Journal | Journal of Clinical Neurology |
Volume | 13 |
Issue number | 4 |
Early online date | 27 Sept 2017 |
DOIs | |
Publication status | Published - Oct 2017 |
Bibliographical note
AcknowledgementWe gratefully acknowledge the data team of the Stroke Services, Norfolk and Norwich University Stroke Research Group.
Keywords
- stroke
- falls
- fractures
- mortality
- prognosis