Department of orthopedics, Kailuan General Hospital, Tangshan, Hebei, China.
the School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China.
BMC Public Health. 2023 May 22;23(1):925. doi: 10.1186/s12889-023-15787-5.
Stroke is a documented risk factor for hip fracture(HF). However, no data is currently available on this issue in mainland China, we therefore assessed the risk of hip fracture after new-onset stroke using a cohort study.
This study included 165,670 participants without a history of stroke at baseline from the Kailuan study. All participants were followed biennially until December 31, 2021. During follow-up, a total of 8,496 new-onset stroke cases were identified. For each case subject, four control subjects was randomly selected, matched for age (± 1 years) and sex. The final analysis comprised 42,455 pair-matched cases and controls. A multivariate Cox proportional hazard regression model was used to estimate the effect of new-onset stroke on the risk of hip fracture.
During an average follow-up of 8.87 (3.94) years, a total of 231 hip fracture cases occurred, 78 cases in the stroke group and 153 cases in the control group, with incidence rates of 1.12 and 0.50 per 1000 person-years, respectively. The cumulative incidence of the stroke group was higher than that of the controls (P < 0.01). The adjusted hazard ratio (95% confidence interval) of hip fractures in the stroke group was 2.35 (1.77 to 3.12) (P < 0.001) to controls. After stratifying by gender, age, and body mass index, the higher risk was revealed in female (HR 3.10, 95 CI: 2.18 to 6.14, P < 0.001), age < 60 years old (HR 4.12, 95% CI: 2.18 to 7.78, P < 0.001), and non-obesity (BMI<28 kg/m) (HR 1.74, 95% CI:1.31 to 2.31, P < 0.001) subgroup.
Stroke significantly increases the risk of hip fracture, strategy for protecting stroke patients from falls and hip fractures should be emphasized in poststroke long-term management, particularly the female, age < 60 years old, and non-obese patients.
中风是髋部骨折（HF）的已知危险因素。然而，目前尚无关于中国大陆这一问题的数据，因此我们使用队列研究评估了新发病例中风后的髋部骨折风险。
本研究纳入了来自开滦研究的 165670 名基线时无中风病史的参与者。所有参与者每两年随访一次，直至 2021 年 12 月 31 日。在随访期间，共确定了 8496 例新发中风病例。对于每个病例患者，随机选择 4 名对照患者，年龄（±1 岁）和性别匹配。最终分析包括 42455 对匹配的病例和对照。使用多变量 Cox 比例风险回归模型来估计新发中风对髋部骨折风险的影响。
在平均 8.87（3.94）年的随访期间，共有 231 例髋部骨折病例发生，其中 78 例发生在中风组，153 例发生在对照组，发病率分别为 1.12 和 0.50/1000 人年。中风组的累积发生率高于对照组（P<0.01）。中风组髋部骨折的调整后危险比（95%置信区间）为 2.35（1.77 至 3.12）（P<0.001）。按性别、年龄和体重指数分层后，女性（HR 3.10，95%CI：2.18 至 6.14，P<0.001）、年龄<60 岁（HR 4.12，95%CI：2.18 至 7.78，P<0.001）和非肥胖（BMI<28kg/m）（HR 1.74，95%CI：1.31 至 2.31，P<0.001）亚组的风险更高。
中风显著增加髋部骨折的风险，在中风后长期管理中应强调预防中风患者跌倒和髋部骨折的策略，特别是女性、年龄<60 岁和非肥胖患者。
