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Prevalence of pre-stroke low bone mineral density and vertebral fracture in first stroke patients
Hye Won Kim1, Eugene Kang2, Sun Im1
1Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, South Korea.
Insights
Many stroke patients have low bone mineral density (BMD) and vertebral fractures before their stroke, increasing fracture risk. Early screening for osteoporosis is crucial after stroke.
Area of Science:
- Neurology
- Orthopedics
- Endocrinology
Background:
- Stroke is associated with factors leading to bone mineral density (BMD) loss and fractures.
- Pre-stroke low BMD and vertebral fractures are linked to increased fracture risk and functional decline post-stroke.
Purpose of the Study:
- To evaluate pre-stroke bone mineral density (BMD) and vertebral fractures in first-time stroke patients.
- To identify the prevalence of osteoporosis and osteopenia in this population.
Main Methods:
- Included 48 patients experiencing their first stroke.
- Assessed pre-stroke BMD via bone densitometry (lumbar spine, hip, femoral neck) within 30 days of stroke onset.
- Evaluated thoracic and lumbar spine X-rays for vertebral fractures.
Main Results:
- 43.8% of stroke patients had osteoporosis, and 39.6% had osteopenia.
- 25.0% had one or more vertebral fractures; 16.7% had two or more.
- Only 33.3% of those with vertebral fractures were previously aware of their condition.
Conclusions:
- High prevalence of pre-stroke low BMD and vertebral fractures observed in first-time stroke patients.
- Bone loss accelerates acutely post-stroke, exacerbating fracture risk and functional loss.
- Urgent screening and management of osteoporosis are critical from the acute stroke phase.
Purpose:
After stroke, many factors contribute to the loss of bone mineral density (BMD) and fracture. Pre-stroke low BMD and vertebral fracture may pose a greater risk of fractures and further contribute to additional functional loss. The purposes of this study were to assess pre-stroke BMD and vertebral fracture in patients with first stroke.
Methods:
Forty-eight patients with first stroke events were included. To reflect pre-stroke BMD, the patients who underwent bone densitometry tests within 30 days from stroke onset were selected. BMD was checked at the lumbar spine and both femurs (total hip and femoral neck). Thoracic and lumbar spine X-rays were performed.
Results:
Of the 48 stroke patients, 21 (43.8%) had osteoporosis and 19 (39.6%) had osteopenia. X-ray evaluation showed that 12 (25.0%) had one or more lumbar or thoracic vertebral fractures and 8 (16.7%) had two or more vertebral fractures. Of the 12 patients who had one or more vertebral fractures, 4 (33.3%) were previously aware of the fact that they had a vertebral fracture.
Conclusion:
Results showed a high prevalence of pre-stroke low BMD and vertebral fracture in patients experiencing first stroke. Bone loss progresses rapidly in the acute stages of stroke, and such a high prevalence of pre-stroke low BMD and vertebral fracture may pose a greater risk of fractures and further contribute to additional functional loss. Therefore, early screening and active management of osteoporosis from the acute stages of stroke is critical.
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