Study Looks at Low Bone Mineral Density and Acute Ischemic Stroke Outcomes

Is Osteoporosis Linked to Poor Outcomes in Stroke Patients?

healthy bone versus osteoporotic boneResearch has shown that chronic low bone mineral density (BMD) is linked to an increased risk of stroke, but little is actually known about the impact of BMD at the time of stroke on clinical outcome. For example, is osteoporosis associated with poor outcomes in stroke patients?

Researchers examined the relationship between BMD and functional disability at 3 months in patients who had an acute ischemic stroke.

Their findings were published online in December 2011 in the article “Low bone mineral density is associated with poor clinical outcome in acute ischemic stroke.” The article will appear in the International Journal of Stroke.

The research team retrospectively examined consecutive acute ischemic stroke patients who had bone densitometry tests within 7 days of the onset of stroke symptoms.

A total of 191 patients participated in the study—61were men (31.9%) and 130 were women (68.1%).

The mean age of the study participants (±standard deviation) was 69.8 ± 11.1 years old.

The following were assessed in the study:

  • Patient demographics
  • Risk factors
  • Initial National Institute of Health Stroke Scale scores

Both lumbar spine and bilateral femoral neck BMD were measured.

For the purposes of this study, osteoporosis was defined as a BMD of ≤-2.5 T-scores at the lumbar spine and bilateral femoral neck.

A modified Rankin Scale at 90 days post-stroke was the primary outcome measurement. For this study, a favorable outcome 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.

After researchers adjusted for age, sex, and initial National Institute of Health Stroke Scale score, they found that osteoporosis of the right femoral neck in the acute post-stroke period was significantly linked to a poor outcome at 3 months (odds ratio: 2.97; 95% confidence interval [CI]: 1.21 to 7.32; p=0.018).

Researchers concluded that the study participants who had osteoporosis of the right femoral neck were more likely to have a poor outcome (25/82; 30.5%) than those participants who did not have osteoporosis (12/109; 11.0%) (p=0.001).

The research team recommends that assessment of bone mineral density in patients with acute stroke may be a useful prognosticator and may also lead to early intervention.

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