Is Osteoporosis Associated with Poor Outcomes in Stroke Patients?
New Study Examines Low Bone Mineral Density and Acute Ischemic Stroke Outcomes
Chronic low bone mineral density (BMD) has been linked to an increased risk of stroke, but very little is known about how bone mineral density at the time of stroke impacts clinical outcome. Is it possible that osteoporosis—including osteoporosis of the lumbar spine—is associated with poor outcomes in stroke patients?
The results of their study were published online in December 2011 in the article “Low bone mineral density is associated with poor clinical outcome in acute ischemic stroke.” It will appear soon in the International Journal of Stroke.
Researchers retrospectively evaluated consecutive acute ischemic stroke patients who had bone densitometry tests within 7 days of the onset of their stroke symptoms.
There were 191 patients who participated in this study; 61 participants were men (31.9%) and 130 participants were women (68.1%).
The mean age of the participants (±standard deviation) was 69.8 ± 11.1 years old.
Three factors were assessed in this study: patient demographics, risk factors, and initial National Institute of Health Stroke Scale scores.
BMD was measured at both the lumbar spine and bilateral femoral necks in all study participants.
Osteoporosis was defined as a BMD of ≤-2.5 T-scores at each of the sites.
The primary outcome measurement for this study was a modified Rankin Scale at 90 days post-stroke. A favorable outcome in the study was defined as a modified Rankin Scale of 0 to 1; a poor outcome was defined as a modified Rankin Scale of 2 to 6.
Researchers adjusted for age, sex, and initial National Institute of Health Stroke Scale score. After they adjusted for these factors, they found that osteoporosis in the right femoral neck in the acute post-stroke period was significantly associated with a poor outcome at 3 months (odds ratio: 2.97; 95% confidence interval [CI]: 1.21 to 7.32; p=0.018).
At the end of the study, the research team concluded that the patients who had osteoporosis of the right femoral neck were more likely to have a poor outcome (25/82; 30.5%) than those who did not have osteoporosis (12/109; 11.0%) (p=0.001).
As a result of their findings, the researchers recommend that assessment of bone mineral density in patients who had an acute stroke may be a useful prognosticator, which may also facilitate early intervention.