Display options
Cite
Foster EJ, Barlas RS, Wood AD, et al. A History of Falls is Associated with a Significant Increase in Acute Mortality in Women after Stroke. J Clin Neurol. 2017;13(4):411-421doi: 10.3988/jcn.2017.13.4.411.
Foster, E. J., Barlas, R. S., Wood, A. D., Bettencourt-Silva, J. H., Clark, A. B., Metcalf, A. K., Bowles, K. M., Potter, J. F., & Myint, P. K. (2017). A History of Falls is Associated with a Significant Increase in Acute Mortality in Women after Stroke. Journal of clinical neurology (Seoul, Korea), 13(4), 411-421. https://doi.org/10.3988/jcn.2017.13.4.411
Foster, Emma J, et al. "A History of Falls is Associated with a Significant Increase in Acute Mortality in Women after Stroke." Journal of clinical neurology (Seoul, Korea) vol. 13,4 (2017): 411-421. doi: https://doi.org/10.3988/jcn.2017.13.4.411
Foster EJ, Barlas RS, Wood AD, Bettencourt-Silva JH, Clark AB, Metcalf AK, Bowles KM, Potter JF, Myint PK. A History of Falls is Associated with a Significant Increase in Acute Mortality in Women after Stroke. J Clin Neurol. 2017 Oct;13(4):411-421. doi: 10.3988/jcn.2017.13.4.411. PMID: 29057634; PMCID: PMC5653630.
Copy Download .nbib Format: NLM
Share it on

J Clin Neurol. 2017 Oct;13(4):411-421. doi: 10.3988/jcn.2017.13.4.411.

A History of Falls is Associated with a Significant Increase in Acute Mortality in Women after Stroke.

Journal of clinical neurology (Seoul, Korea)

Emma J Foster, Raphae S Barlas, Adrian D Wood, Joao H Bettencourt-Silva, Allan B Clark, Anthony K Metcalf, Kristian M Bowles, John F Potter, Phyo K Myint

Affiliations

  1. Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK.
  2. Norfolk and Norwich University Hospital, Norwich, UK.
  3. Norwich Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.
  4. Norwich Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK. [email protected].

PMID: 29057634 PMCID: PMC5653630 DOI: 10.3988/jcn.2017.13.4.411

Abstract

BACKGROUND AND PURPOSE: The risks of falls and fractures increase after stroke. Little is known about the prognostic significance of previous falls and fractures after stroke. This study examined whether having a history of either event is associated with poststroke mortality.

METHODS: We analyzed stroke register data collected prospectively between 2003 and 2015. Eight sex-specific models were analyzed, to which the following variables were incrementally added to examine their potential confounding effects: age, type of stroke, Oxfordshire Community Stroke Project classification, previous comorbidities, frailty as indicated by the prestroke modified Rankin Scale score, and acute illness parameters. Logistic regression was applied to investigate in-hospital and 30-day mortality, and Cox proportional-hazards models were applied to investigate longer-term outcomes of mortality.

RESULTS: In total, 10,477 patients with stroke (86.1% ischemic) were included in the analysis. They were aged 77.7±11.9 years (mean±SD), and 52.2% were women. A history of falls was present in 8.6% of the men (n=430) and 20.2% of the women (n=1,105), while 3.8% (n=189) of the men and 12.9% of the women (n=706) had a history of both falls and fractures. Of the outcomes examined, a history of falls alone was associated with increased in-hospital mortality [odds ratio (OR)=1.33, 95% confidence interval (CI)=1.03-1.71] and 30-day mortality (OR=1.34, 95% CI=1.03-1.73) in women in the fully adjusted models. The Cox proportional-hazards models for longer-term outcomes and the history of falls and fractures combined showed no significant results.

CONCLUSIONS: The history of falls is an important factor for acute stroke mortality in women. A previous history of falls may therefore be an important factor to consider in the short-term stroke prognosis, particularly in women.

Copyright © 2017 Korean Neurological Association

Keywords: falls; fractures; mortality; prognosis; stroke

Conflict of interest statement

The authors have no financial conflicts of interest.

References

  1. Methods Inf Med. 2012;51(3):210-20 - PubMed
  2. Acta Neurol Scand. 2017 May;135(5):553-559 - PubMed
  3. Hong Kong Med J. 2015 Apr;21(2):165-71 - PubMed
  4. Osteoporos Int. 2015 Feb;26(2):645-52 - PubMed
  5. Arch Biochem Biophys. 2010 Nov 1;503(1):153-9 - PubMed
  6. BMJ. 2003 Jul 12;327(7406):89-95 - PubMed
  7. Stroke. 2013 Jul;44(7):2010-2 - PubMed
  8. Stroke. 2007 Jun;38(6):1873-80 - PubMed
  9. Eur J Epidemiol. 2009;24(7):351-5 - PubMed
  10. Stroke. 2016 Jun;47(6):1673-8 - PubMed
  11. QJM. 2007 Sep;100(9):539-45 - PubMed
  12. J Bone Miner Res. 2013 Mar;28(3):516-23 - PubMed
  13. Am J Epidemiol. 2015 Apr 1;181(7):521-31 - PubMed
  14. Stroke. 2002 Mar;33(3):728-34 - PubMed
  15. Stroke. 2005 Jun;36(6):1316-29 - PubMed
  16. Stroke. 2014 Feb;45(2):373-82 - PubMed
  17. J Nutr Health Aging. 2012 Oct;16(10):903-7 - PubMed
  18. Age Ageing. 2013 Sep;42(5):594-8 - PubMed
  19. Cerebrovasc Dis. 2010 Jan;29(2):130-6 - PubMed
  20. BMJ. 2016 Feb 03;352:i245 - PubMed
  21. Int J Stroke. 2014 Apr;9(3):278-83 - PubMed
  22. Stroke. 1993 Jul;24(7):940-6 - PubMed
  23. Heart. 2012 May;98 (9):712-7 - PubMed
  24. Lancet. 1991 Aug 10;338(8763):355-8 - PubMed
  25. Stroke. 2003 May;34(5):e20-2 - PubMed
  26. Stroke. 2001 Jan;32(1):47-51 - PubMed
  27. Stroke. 2004 May;35(5):1147-52 - PubMed
  28. J Rehabil Res Dev. 2013;50(9):1277-86 - PubMed

Publication Types