Low Bone Mineral Density as a Predictor of Mortality and Infections in Stroke Patients: A Hospital-Based Study

• Published in: The journal of clinical endocrinology and metabolism 2024-11, Vol.109 (12), p.3055-3064
• Main Authors: Tsai, Yu-Lin, Chuang, Ya-Chi, Cheng, Yuan-Yang, Deng, Ya-Lian, Lin, Shih-Yi, Hsu, Chun-Sheng
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Bone Density; Bone Diseases, Metabolic - epidemiology; Bone Diseases, Metabolic - mortality; Bone mineral density; Female; Femur; Humans; Male; Middle Aged; Mortality; Osteopenia; Osteoporosis; Osteoporosis - epidemiology; Osteoporosis - mortality; Pneumonia - complications; Pneumonia - epidemiology; Pneumonia - mortality; Population studies; Prognosis; Retrospective Studies; Risk Factors; Stroke; Stroke - complications; Stroke - epidemiology; Stroke - mortality; Survival; Survival Rate; Taiwan - epidemiology; Urinary tract; Urinary tract infections; Urinary Tract Infections - epidemiology; Urinary Tract Infections - mortality
• ISSN: 0021-972X; 1945-7197; 1945-7197
• DOI: 10.1210/clinem/dgae365

Abstract Context Low bone mineral density (BMD) has been linked to elevated risks of mortality and infections in the general population; however, its association with these outcomes in stroke patients remains unclear. Objective This study aims to investigate the correlation between low BMD and risks of mortality and infections among stroke patients in a Taiwanese cohort. Methods In this single-center retrospective cohort study, 905 stroke patients from a Taiwanese database (2000-2022) were analyzed. Patients were grouped based on BMD measurements of the femur and spine. The primary outcome was all-cause mortality, and secondary outcomes included urinary tract infection (UTI) and pneumonia. Accelerated failure time regression model analyses evaluated the association between BMD and these outcomes, while the Kaplan-Meier method and log-rank test assessed survival differences between groups. Results Among the participants (average age 76.1 years, 70.5% female), 33.82% had osteopenia and 55.25% had osteoporosis. Stroke patients with lower spine and right femur BMD had significantly reduced survival rates, especially when the BMD value fell below 0.842 g/cm2 (spine), and 0.624 g/cm2 (right femur), respectively. Regarding secondary outcomes, lower spine BMD was significantly associated with an increased risk of UTI. Conclusion Low BMD, particularly in the femur and spine, is a significant predictor of mortality and UTI in stroke patients. These findings highlight the importance of assessing and managing BMD in stroke patients to improve outcomes and reduce complications.