Falls following stroke: What are the risk factors?
From Institute of Psychiatry and Neurology in Poland, two authors were aiming to assess the incidence and circumstances of falls among stroke patients in a rehabilitation ward, the frequency of fall-related fractures, the relationship between falls and rehabilitation outcomes, and risk factors for falls.
The results of the study which was a prospective one and published recently (Clinical Rehabilitation 2009 Feb; 23(2):176-88) showed that in total 1155 patients (56% men; mean age 61.5 +/- 14.3 years) admitted to the neurological rehabilitation ward after a stroke. Median time since stroke onset was 36.5 (68) days.
A total of 252 falls were recorded for 189 (16.3%) patients and 45 patients experienced 108 repeated falls. The incidence rate for falls was 7.6/1000 patient-days. Most patients fell while being transferred (33.9%) and while seated (21.5%), and 1.2% of falls resulted in fractures (n = 3). Increased risk of both first and multiple falls was strongly associated with initial Barthel score below 15 and time since stroke onset >/=12 weeks. First falls were significantly associated with visuo-spatial neglect. Repeated falls were related to age greater than 65 years.
The study concluded that patients with severe stroke-related disability in the early period after stroke are prone to falls during rehabilitation. Multiple falls are most frequent in patients over 65 years of age.