Differences in Fracture Incidence According to Caregiver Type in Stroke Survivors

Juyeong Kim, Kyoung Hee Cho, Sang Gyu Lee, Ye Seol Lee, Sung In Jang, Eun Cheol Park

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4 Citations (Scopus)


Background: To assess whether the type of primary caregiver is a risk factor of the incidence of fracture among older adults who have survived a stroke. Methods: Data from 4282 stroke survivors in the National Health Insurance Service—Senior Cohort (2002-2013) were used in this study. We categorized type of primary caregiver as none, spouse/family caregiver, and formal caregiver. The incidence of fracture within the year postdischarge was used as the outcome variable. These data were subjected to a survival analysis using the Cox proportional hazard model. Results: Of the 4282 stroke survivors, 308 (7.2%) experienced a fracture during the 1-year follow-up period. According to type of primary caregiver, the adjusted hazard ratio (HR) of fracture was lower among those whose caregiver was a spouse (HR =.68, 95% confidence interval [CI],.48-.96] and those with a formal caregiver (HR =.59, 95% CI,.36-.97) compared to stroke survivors with no caregiver. In particular, those with a family or formal caregiver who were being cared for in nursing facilities were less likely to be associated with fracture than those with no caregiver. Conclusions: The adjusted HR of fracture among stroke survivors was lower among those with primary caregivers compared to those without them. Thus, the government should monitor and allocate the appropriate attention to stroke survivors after discharge in order to ensure that they obtain the needed health care, especially for stroke survivors who are without a primary caregiver.

Original languageEnglish
Pages (from-to)2849-2856
Number of pages8
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number10
Publication statusPublished - 2018 Oct

Bibliographical note

Funding Information:
The authors appreciate the administrative support provided by the Yonsei University Institute of Health Services Research. Authors’ contributions Juyeong Kim (first author), Kyoung Hee Cho (second author), Sang Gyu Lee (third author), Ye Seol Lee (fourth author), Sung-In Jang (corresponding author), and Eun-Cheol Park (sixth author) directly participated in the planning, execution, and analysis of the study. Authorship This manuscript has been read and approved by all authors and all authors agree to the submission of the manuscript.

Publisher Copyright:
© 2018

All Science Journal Classification (ASJC) codes

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


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