Abstract P402: Association Between Post-stroke Disability and 5-year Hip-fracture Risk: the Women’s Health Initiative
Notice bibliographique
Résumé
Background: Hip fractures are a significant post-stroke complication. While studies have shown an increased incidence of hip fractures post-stroke, the relationship between stroke-related disability and hip fracture rates are not well characterized. Herein, we examine factors associated with hip fracture risk after stroke using the Women’s Health Initiative (WHI) data. Methods: The WHI is a prospective study of 161,808 postmenopausal women aged 50-79 years. In the WHI, stroke cases were initially self-reported and then confirmed by a neurologist adjudication using medical records and a manual. Hip fracture cases were self-reported and then radiologically confirmed by physician adjudication. We included stroke survivors from the observational and clinical trial arms who had a Glasgow Outcome Score (GOS) of 1-3 (good recovery, moderately disabled, severely disabled) and survived at least one week after stroke (n=4,640). Survival free from any radiologically-confirmed hip fracture post-stroke was estimated and compared by GOS status. Secondary analysis examined the post-stroke hip fracture risk while accounting for the competing risk of death. Results: There were 124 hip fractures. Average age of stroke was 74.6 ± 7.2 years. Mean follow-up time was 3.1±1.8 years. Hip fractures by GOS status represented 2.4% (45/1872), 2.5% (34/1366), and 3.5% (45/1278) among good recovery, moderately disabled, and severely disabled. In the competing risk model, 23.3% (1079/4640) of the participants died before the end of follow-up or the occurrence of a hip fracture. Severely disabled (HR: 2.1 (95% CI: 1.3, 3.2), p=0.001) status, but not moderately disabled (HR: 1.1 (95% CI: 0.7, 1.7) p=0.8), was significantly associated with an increase in risk of hip fracture compared to good recovery status. This association was attenuated and not significant for moderately disabled (HR: 1.1 (95%CI: 0.7, 1.7), p=0.8) and severely disabled (HR 1.5 (95%CI: 1.0, 2.3), p=0.06) status when accounting for mortality after stroke. High Hip Fracture Risk Assessment Tool (FRAX) risk (without bone density information), being Caucasian, and increasing age were associated with an increased post stroke hip fracture risk. When accounting for mortality after stroke, higher FRAX-predicted hip fracture risk and race/ethnicity remained significant. The association between age and hip fracture was attenuated and not significant after accounting for post-stroke mortality. Conclusion: Among stroke survivors, severely disabled status and FRAX-predicted hip fracture risk were associated with a higher risk of subsequent radiologically confirmed hip fracture, but only the FRAX-predicted hip fracture risk association remained significant when considering the competing risk of mortality after stroke. Interventions to reduce fracture risk after stroke should be evaluated in clinical trials.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».