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Fracture risk was increased after stroke with a marked increase immediately after stroke

Main results 24 666 people (9%) had a fracture subsequent to stroke, of which 14 263 (58%) were hip fractures. The incidence of all fractures and hip fractures in patients with stroke was compared with the general population. For any fracture requiring admission to hospital, the relative risk (RR) was greatest in the younger age groups (RR 2.38 to 4.69). RR declined with age but was still increased in the population >95 years of age (RR 1.43 to 2.64). The RR was higher in women than in men. The increase in risk was most marked immediately after stroke, intermediate at 6 months, and lowest at 4 years. For hip fractures, the pattern was similar to that for all fractures, but the RRs were higher. For example, the risk of any fracture requiring admission to hospital immediately after stroke was 3.7 in women aged 50–54 years whereas the risk of hip fracture was 11.8. At all ages and in both sexes, there was a marked increase in the risk of fracture within the first year of stroke compared with the general population. Thereafter, the risk decreased but did not attain the level of the general population except in men and women >80 years of age. The association between fracture risk and duration of hospital stay differed between the sexes. In men the risk for any fracture increased by 2.3% for every additional 10 days in hospital, and the risk for hip fracture increased by 4.0%. For women the risk decreased with duration of hospital stay by 1.1% for all fractures; risk of hip fracture was not associated with duration of hospital stay.