Sohn Jong-Hee, Kim Chulho, Kim Yerim, Park So Young, Lee Sang-Hwa
Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 24252, Republic of Korea.
Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea.
J Clin Med. 2023 Jul 26;12(15):4905. doi: 10.3390/jcm12154905.
This study evaluated whether osteoporosis pharmacotherapy (OPT) affected functional outcomes in acute ischemic stroke patients with osteoporosis. Using a single-center registry database, we consecutively registered acute ischemic stroke patients between May 2016 and December 2020. All patients older than 55 years underwent routine bone densitometry within 7 days of stroke onset. OPT prescription was confirmed by reviewing medical records. We classified the patients into OPT and no OPT groups. We performed propensity score matching (PSM) to overcome the imbalance in multiple covariates between the two groups. We investigated whether OPT affected 1-year functional outcomes by multivariate analysis using a PSM cohort. Among 1307 consecutively registered acute ischemic stroke patients, 381 patients were enrolled in this study, of whom 134 (35.2%) were prescribed OPT at discharge, which was maintained for 1 year. In a multivariate analysis using a PSM cohort, the OPT group had a lower risk of dependency (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.27-0.996) and poor functional outcome at 1 year (OR, 0.24; 95% CI, 0.10-0.57). The OPT group also had increased chance of late functional improvement (OR, 6.16; 95% CI, 1.12-33.79). This study showed that OPT could reduce dependency and poor functional outcomes and increase the chance of improving functional outcomes at 3 months and 1 year after ischemic stroke onset, and these findings could be helpful for improving functional outcomes and bone health after ischemic stroke.
本研究评估了骨质疏松症药物治疗（OPT）是否会影响急性缺血性脑卒中合并骨质疏松症患者的功能结局。利用单中心登记数据库，我们连续登记了2016年5月至2020年12月期间的急性缺血性脑卒中患者。所有年龄大于55岁的患者在卒中发作7天内接受常规骨密度测定。通过查阅病历确认OPT处方。我们将患者分为OPT组和非OPT组。我们进行倾向得分匹配（PSM）以克服两组之间多个协变量的不平衡。我们使用PSM队列通过多变量分析研究OPT是否会影响1年的功能结局。在连续登记的1307例急性缺血性脑卒中患者中，381例患者纳入本研究，其中134例（35.2%）在出院时开具了OPT处方，并维持1年。在使用PSM队列的多变量分析中，OPT组在1年时依赖风险较低（优势比[OR]，0.52；95%置信区间[CI]，0.27 - 0.996）且功能结局较差（OR，0.24；95%CI，0.10 - 0.57）。OPT组后期功能改善的机会也增加（OR，6.16；95%CI，1.12 - 33.79）。本研究表明，OPT可降低缺血性卒中发作后3个月和1年时的依赖程度和不良功能结局，并增加改善功能结局的机会，这些发现可能有助于改善缺血性卒中后的功能结局和骨骼健康。
