| 제목 |
The Clinical Manifestations of Patients with Hip Fracture after Stroke |
| 소속 |
Kyung Hee University Hospital at Gangdong, Department of Rehabilitation Medicine1, Kyung Hee University Medical Center, Department of Rehabilitation Medicine2 |
| 저자 |
Seung Don Yoo M.D.1†, Hee-Sang Kim M.D.2, Jong Ha Lee M.D.2, Dong Hwan Yun M.D.2, Dong Hwan Kim M.D.1, Jinmann Chon M.D.2, Seung Ah Lee M.D.1, Yun Soo Soh M.D.2, Yong Kim M.D.2, Young Rok Han M.D.1, Myung Chul Yoo M.D.2, Min Kyu Choi M.D.1* |
Objective : Hip fracture in patients with stroke is a major complication that increases mortality. It can be expected that low bone mineral density and decreased functional ability will increase hip fracture risk. In previous studies, low serum hemoglobin levels may be a risk factor for osteoporotic fracture and hip fracture. The Charlson Comorbidity Index is designed to predict long-term survival and surgical mortality, and is evaluated using the patient's underlying diseases. The aim of this study is to examine the clinical manifestations of patients with hip fracture after stroke by evaluating bone mineral density, serum hemoglobin level, functional ability, and underlying diseases assessed by the Charlson Comorbidity Index.
Method : A case-control study was conducted of patients with stroke who had hospitalized from January 2015 to February 2020. For inclusion criteria, patients who measured bone mineral density within 3 months of stroke onset and those who had hip fracture were included. The assessment factors consists of sex, age, body mass index, bone mineral density (BMD) measured in lumbar spine and proximal femur, Modified Barthel Index (K-MBI), Mini-Mental State Examination (MMSE), Manual Muscle Testing grading (MMT) of hip flexor, hemoglobin level measured before hip fracture occurs, and the Charlson Comorbidity Index (CCI). Anemia was defined when hemoglobin level was less than 13 in men and less than 12 in women. Mann-Whitney U-test was used to compare between the case and control groups, and logistic regression analysis was used to assess the association between each parameters and hip fracture.
Results : Case (n=20) and control (n=60) subjects were not statistically different with respect to age and sex. Logistic regression analysis show that BMD of proximal femur (p=0.018, odds ratio=0.305) and serum hemoglobin (p=0.020, odds ratio=0.553) were associated with hip fracture in patients with stroke. However, when comparing the two groups for BMD of lumbar spine, K-MBI, MMT, CCI, there was no statistically significant difference.
Conclusion : This study showed that BMD of proximal femur and serum hemoglobin were correlated with hip fracture in patients with stroke. This finding suggests that management of osteoporosis and anemia may lower the risk of hip fracture in patients with stroke. |
|
Table 1. Baseline characteristics of case and control group
Table 2. BMD and hemoglobin of case and control group
Table 3. Logistic regression analysis of parameters as a predictor of hip fracture
|
