The risk of stroke after percutaneous vertebroplasty for osteoporosis: a population-based cohort study

• Published in: PloS one 2012-01, Vol.7 (1), p.e31405-e31405
• Main Authors: Wu, Ching-Lan, Wu, Jau-Ching, Huang, Wen-Cheng, Wu, Hung-Ta H, Chiou, Hong-Jen, Liu, Laura, Chen, Yu-Chun, Chen, Tzeng-Ji, Cheng, Henrich, Chang, Cheng-Yen
• Format: Article
• Language: English
• Subjects: Aged; Biocompatibility; Bone surgery; Cement; Clinical outcomes; Cohort analysis; Cohort Studies; Demographics; Demography; Embolisms; Female; Fractures; Health care; Health insurance; Health risks; Hearing loss; Hemorrhage; Hospitals; Humans; Incidence; Interdisciplinary aspects; Ischemia; Male; Medical research; Medicine; Neurosurgery; Orthopedic surgery; Osteoporosis; Osteoporosis - epidemiology; Osteoporosis - surgery; Patients; Population; Population studies; Population-based studies; Proportional Hazards Models; Regression analysis; Regression models; Risk; Risk Factors; Socioeconomic Factors; Stroke; Stroke - epidemiology; Stroke - etiology; Taiwan - epidemiology; Vertebroplasty - adverse effects
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0031405

To investigate the incidence and risk of stroke after percutaneous vertebroplasty in patients with osteoporosis. A group of 334 patients with osteoporosis, and who underwent percutaneous vertebroplasty during the study period, was compared to 1,655 age-, sex- and propensity score-matched patients who did not undergo vertebroplasty. All demographic covariates and co-morbidities were deliberately matched between the two groups to avoid selection bias. Every subject was followed-up for up to five years for stroke. Adjustments using a Cox regression model and Kaplan-Meier analyses were conducted. A total of 1,989 osteoporotic patients were followed up for 3,760.13 person-years. Overall, the incidence rates of any stroke, hemorrhagic stroke and ischemic stroke were 22.6, 4.2 and 19.6 per 1,000 person-years, respectively. Patients who underwent vertebroplasty were not more likely to have any stroke (crude hazard ratio = 1.13, p = 0.693), hemorrhagic stroke (HR = 2.21, p = 0.170), or ischemic stroke (HR = 0.96, p = 0.90). After adjusting for demographics, co-morbidities and medications, the vertebroplasty group had no significant difference with the comparison group in terms of any, hemorrhagic and ischemic strokes (adjusted HR = 1.22, 3.17, and 0.96, p = 0.518, 0.055, and 0.91, respectively). Osteoporotic patients who undergo percutaneous vertebroplasty are not at higher risk of any stroke in the next five years after the procedure.