It's because you didn't get them 100% recovered you have to worry about this problem.
Impact of Poststroke Fracture on Quality of Life: Insights From a Retrospective Cohort Study
Stroke survivors face a multitude of challenges on their road to recovery, and recent research has shed light on a particularly concerning issue: an increased risk of fractures among this population. While some factors contributing to this elevated risk, such as age, gender, medications, and comorbidities, have been identified, a comprehensive understanding of how stroke affects fracture rates and its subsequent impact on health-related quality of life (HRQoL) has remained elusive.
In a pivotal contribution to the field, Dalli et al. conducted a retrospective cohort study that not only compared the annualized fracture rate before and after stroke or transient ischemic attack (TIA), but also delved into the intricate relationship between fracture and HRQoL. Their data, drawn from the Australian Stroke Clinical Registry (AuSCR), provided valuable insights from 13,594 adult survivors of stroke or TIA (49.7% were aged >=75 years, 45.5% were female, and 47.9% were unable to walk on admission).
The study’s findings were compelling, revealing a stark increase in fracture rates following stroke or TIA, with a 63% (95% CI, 47%-80%) relative rise in fracture in the year following the event. Hip fractures emerged as the most common type in both stroke and TIA cohorts, and a staggering 86% of poststroke fractures were attributed to falls. While some risk factors for fractures overlapped between stroke and TIA cohorts, such as age, gender, prior fractures, and comorbidities, there were notable distinctions. For instance, hypertension was associated with a reduced fracture incidence after TIA, and patients receiving care in a stroke unit had a 33% lower fracture risk. The impact on HRQoL was profound, with patients who experienced fractures reporting worsened HRQoL in various dimensions, including mobility, self-care, usual activities, and pain/discomfort. These findings translated into a clinically meaningful 0.11-point reduction in overall health status per EQ-5D-3L utility scores.
In essence, this study not only reaffirmed the heightened fracture risk poststroke, but also emphasized the urgent need to address this issue to enhance the quality of life among stroke survivors. Poststroke fractures increase mortality and contribute to dependence, mobility challenges, and the need for residential care. To mitigate this concerning trend, comprehensive fall risk screening and preventive strategies are imperative after stroke and TIA. Moreover, the unique risk factors identified in this study should serve as a foundation for future research to unravel the underlying mechanisms behind falls in these patients. The striking finding that females are nearly 50% more likely to experience poststroke fractures than men underscores the importance of gender-specific interventions. Exploring evidence-based approaches, such as weight-bearing exercises and osteoporosis treatments like bisphosphonates, is crucial in reducing fracture risks among female stroke survivors.
As the number of stroke survivors living longer continues to rise, their quality of life becomes an increasingly important concern. As highlighted in this study, the negative impact of poststroke fractures on HRQoL affects multiple aspects of survivors’ lives. It carries significant implications for individuals, families, and society at large. Addressing this issue through tailored programs and longitudinal studies to monitor HRQoL changes over time is essential to improve the well-being of stroke survivors and enhance our understanding of this critical aspect of their recovery journey.
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