Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
PLoS One. 2012;7(1):e31405. doi: 10.1371/journal.pone.0031405. Epub 2012 Jan 31.
To investigate the incidence and risk of stroke after percutaneous vertebroplasty in patients with osteoporosis.
A group of 334 patients with osteoporosis, and who underwent percutaneous vertebroplasty during the study period, was compared to 1,655 age-, sex- and propensity score-matched patients who did not undergo vertebroplasty. All demographic covariates and co-morbidities were deliberately matched between the two groups to avoid selection bias. Every subject was followed-up for up to five years for stroke. Adjustments using a Cox regression model and Kaplan-Meier analyses were conducted.
A total of 1,989 osteoporotic patients were followed up for 3,760.13 person-years. Overall, the incidence rates of any stroke, hemorrhagic stroke and ischemic stroke were 22.6, 4.2 and 19.6 per 1,000 person-years, respectively. Patients who underwent vertebroplasty were not more likely to have any stroke (crude hazard ratio = 1.13, p = 0.693), hemorrhagic stroke (HR = 2.21, p = 0.170), or ischemic stroke (HR = 0.96, p = 0.90). After adjusting for demographics, co-morbidities and medications, the vertebroplasty group had no significant difference with the comparison group in terms of any, hemorrhagic and ischemic strokes (adjusted HR = 1.22, 3.17, and 0.96, p = 0.518, 0.055, and 0.91, respectively).
Osteoporotic patients who undergo percutaneous vertebroplasty are not at higher risk of any stroke in the next five years after the procedure.
调查骨质疏松症患者行经皮椎体成形术后中风的发生率和风险。
将研究期间接受经皮椎体成形术的 334 例骨质疏松症患者与未接受椎体成形术的 1655 例年龄、性别和倾向评分匹配的患者进行比较。两组患者均仔细匹配了所有人口统计学协变量和合并症，以避免选择偏倚。每位患者均随访长达五年，以观察中风情况。采用 Cox 回归模型和 Kaplan-Meier 分析进行调整。
共有 1989 例骨质疏松症患者随访了 3760.13 人年。总体而言，任何中风、出血性中风和缺血性中风的发生率分别为 22.6、4.2 和 19.6/1000 人年。接受椎体成形术的患者发生任何中风的风险并不更高（粗危险比=1.13，p=0.693）、出血性中风（HR=2.21，p=0.170）或缺血性中风（HR=0.96，p=0.90）。在调整了人口统计学因素、合并症和药物治疗后，椎体成形术组与对照组在任何中风、出血性中风和缺血性中风方面均无显著差异（调整后的 HR=1.22、3.17 和 0.96，p=0.518、0.055 和 0.91，分别）。
在术后的接下来五年内，接受经皮椎体成形术的骨质疏松症患者发生任何中风的风险没有增加。
