White matter lesions are associated with hospital admissions because of hip-fractures and trauma after ischemic stroke

Gerli Sibolt, Sami Curtze, Susanna Melkas, Tarja Pohjasvaara, Markku Kaste, Pekka J. Karhunen, Niku K J Oksala, Timo Strandberg, Timo Erkinjuntti

Research output: Contribution to journalArticleScientificpeer-review

10 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE -: Cerebral white matter lesions (WMLs), a surrogate for cerebral small-vessel disease, have been shown to be associated with decreasing mobility, gait instability, and falls. The aim of this study was to investigate whether WMLs of the brain are associated with increased incidence of hospital admissions because of any trauma and hip-fractures in a cohort of patients with stroke. METHODS -: We included 383 consecutive patients aged 55 to 85 years with ischemic stroke admitted to the Helsinki University Central Hospital (The Stroke Aging Memory cohort) with a 12-year follow-up. National register data were reviewed for hip-fractures, other traumatic injuries, survival data, and causes of death. WMLs were rated using MRI and dichotomized as none to mild and moderate to severe. The data were analyzed using Kaplan-Meier plots (log-rank) and a complex Cox multivariable hazards models for multiple cases per subject to assess hazard ratios with their 95% confidence intervals. RESULTS -: During the 12-year follow-up, there were more hip-fractures (13.5% versus 6.5%: log-rank, P=0.01) and more hospital admissions because of traumatic injury (22.2% versus 16.7%: log-rank, P=0.04) in the moderate-to-severe than in the none-to-mild WMLs group. In the complex samples, Cox multivariable model adjusting for age, sex, National Institutes of Health Stroke Scale, infarct size, and poststroke dementia, moderate-to-severe WMLs were associated with increased incidences of hospital admissions because of hip-fractures (hazard ratio, 3.98: 95% confidence interval, 1.55-10.21) and traumatic injuries including hip-fractures (hazard ratio, 1.72: 95% confidence interval, 1.03-2.87). CONCLUSIONS -: Patients with ischemic stroke and moderate-to-severe WMLs are at high risk, who experience serious traumatic injuries and especially hip-fractures requiring hospital treatment.

Original languageEnglish
Pages (from-to)2948-2951
Number of pages4
JournalStroke
Volume45
Issue number10
DOIs
Publication statusPublished - 2014
Publication typeA1 Journal article-refereed

Keywords

  • cerebral small vessel diseases
  • hip fractures
  • trauma

Publication forum classification

  • Publication forum level 3

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