Turkish Journal of Geriatrics 2021 , Vol 24, Issue 2
OSTEOPOROSIS AND HIP-FRACTURE RISK ASSESSMENT USING DIFFERENT TOOLS IN THE FIRST YEAR AFTER STROKE
Nurdan PAKER1, Derya BUĞDAYCI1, Halime KİBAR2, Yelda SOLUK ÖZDEMİR1
1İstanbul Physical Medicine and Rehabilitation Training and Research Hospital, Physical Medicine and Rehabilitation, istanbul, Turkey
2Bağcılar Training and Research Hospital, Physical Medicine and Rehabilitation, İstanbul, Turkey
DOI : 10.31086/tjgeri.2021.209 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. Keywords : Stroke; Hemiplegia; Osteoporosis; Bone Density