OSTEOPOROSIS AND HIP-FRACTURE RISK ASSESSMENT USING DIFFERENT TOOLS IN THE FIRST YEAR AFTER STROKE

Purpose: The aim of this study was to ascertain the frequency of osteoporosis and 10-year hip-fracture risk in patients with post-stroke hemiplegia using two different assessment algorithms. Method: Seventy-seven patients with post-stroke hemiplegia <= 1 year who were admitted to the stroke unit of a tertiary rehabilitation hospital were included in this cross-sectional study. All patients underwent bone density assessment. Fracture risk assessment tool (FRAX) and QFracture were both used to calculate the 10-year risk probability for hip fracture. Receiver operating characteristic curves were investigated for FRAX and QFracture. Results: Fifteen patients (19.5%) had osteoporosis, and 39 (50.6%) had osteopenia based on dual-energy X-ray absorptiometry measurements. FRAX hip scores were >= 3 in 7 patients (9.1%). Ten-year hip-fracture risk was high in 26 patients (33.8%) using QFracture. Six patients (7.8%) had low-energy fractures after stroke. Fracture sites were hip in 2 patients, 1 humerus, 1 forearm, and 2 in lower extremities. The receiver operating characteristic area under curve was 0.804 (% 95 CI 0.665-0.943, p = 0.002) for FRAX and 0.758 (% 95 CI 0.615-0.901, p = 0.009) for QFracture. Cut-off values for the estimation of hip osteoporosis for FRAX and QFracture tools were 1.15 and 1.55, respectively. Conclusion: Findings indicated that 70.1% of patients in this study had osteoporosis or osteopenia within the first year following a stroke. Ten-year hip-fracture risk was 9.1% by FRAX and 33.8% by QFracture. Results of FRAX and QFracture assessment tools demonstrated a significant relationship between ten-year hip-fracture risk and bone mineral density.