(Stroke. 1997;28:297-301.)
© 1997 American Heart Association, Inc.
Articles |
Risk Factors for Falls of Hospitalized Stroke Patients
the Departments of Neurology (J.A.T., M.L.) and Clinical Epidemiology and Biostatistics (J.H.P.v.d.M., R.J.d.H.) and the Institute of Social Medicine (A.v.S.), Academic Medical Center, University of Amsterdam (Netherlands).
Correspondence to J.A. Tutuarima, RN, Department of Neurology, H6-252, Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, The Netherlands. E-mail J.A.Tutuarima@amc.uva.nl.
Background and Purpose Patients with stroke are at a high risk for falling. We assessed the fall incidence and risk factors for patients hospitalized as the result of an acute stroke.
Methods We studied a cohort of 720 stroke patients from 23 hospitals in The Netherlands. The data were abstracted from the medical and nursing records.
Results We studied 346 women and 374 men with a median age of 75 years; 77% of the patients had had a cerebral infarct, 17% had had a hemorrhage, and 6% had had an undefined stroke. We recorded 104 patients (14%) who fell at least once; there were a total of 173 falls. The incidence of falls was 8.9/1000 patients per day. The daily incidence was 6.2/1000 patients for first falls and 17.9/1000 patients for second falls. Heart disease (relative risk [RR], 1.6; 95% confidence interval [CI], 1.0 to 2.4), mental decline (RR, 1.6; 95% CI, 1.0 to 2.4), and urinary incontinence (RR, 2.3; 95% CI, 1.3 to 4.1) were incremental risk factors for first falls, whereas the use of major psychotropic drugs lowered the fall risk (RR, 0.5; 95% CI, 0.3 to 0.8). The fall RR for patients with one previous fall was 2.2 (95% CI, 1.5 to 3.2), adjusted for the other risk factors. Most falls occurred during the day. Approximately 25% of the falls caused slight-to-severe injury, whereas three falls (2%) led to hip fractures.
Conclusions Stroke patients have a high risk of falling. The identification of patients at risk may be a first step toward the implementation of fall-prevention measures for these patients.
Key Words: accidental falls • cerebrovascular disorders • risk factors • incidences
This article has been cited by other articles:
 |
|
 |
|
  K. Takatori, Y. Okada, K. Shomoto, and T. Shimada Does assessing error in perceiving postural limits by testing functional reach predict likelihood of falls in hospitalized stroke patients? Clinical Rehabilitation, June 1, 2009; 23(6): 568 - 575. [Abstract] [PDF]
|
|
|
|
|
|
A. Czernuszenko and A. Czlonkowska Risk factors for falls in stroke patients during inpatient rehabilitation Clinical Rehabilitation, February 1, 2009; 23(2): 176 - 188. [Abstract] [PDF]
|
|
|
|
 |
|
 A. P. Yelnik, F. Le Breton, F. M. Colle, I. V. Bonan, C. Hugeron, V. Egal, E. Lebomin, J.-P. Regnaux, D. Perennou, and E. Vicaut Rehabilitation of Balance After Stroke With Multisensorial Training: A Single-Blind Randomized Controlled Study Neurorehabil Neural Repair, September 1, 2008; 22(5): 468 - 476. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Ashburn, D. Hyndman, R. Pickering, L. Yardley, and S. Harris Predicting people with stroke at risk of falls Age Ageing, May 1, 2008; 37(3): 270 - 276. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Thurman, J. A. Stevens, and J. K. Rao Practice Parameter: Assessing patients in a neurology practice for risk of falls (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology Neurology, February 5, 2008; 70(6): 473 - 479. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation, May 22, 2007; 115(20): e478 - e534. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists Stroke, May 1, 2007; 38(5): 1655 - 1711. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Calkins and C. Cassella Exploring the Cost and Value of Private Versus Shared Bedrooms in Nursing Homes Gerontologist, April 1, 2007; 47(2): 169 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Holloway, D. Tuttle, T. Baird, and W. K. Skelton The safety of hospital stroke care Neurology, February 20, 2007; 68(8): 550 - 555. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S F. Mackintosh, K Hill, K J Dodd, P Goldie, and E Culham Falls and injury prevention should be part of every stroke rehabilitation plan Clinical Rehabilitation, April 1, 2005; 19(4): 441 - 451. [Abstract] [PDF]
|
|
|
|
 |
|
 J. E Harris, J. J Eng, D. S Marigold, C. D Tokuno, and C. L Louis Relationship of Balance and Mobility to Fall Incidence in People With Chronic Stroke Physical Therapy, February 1, 2005; 85(2): 150 - 158. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Adams Jr, R. J. Adams, T. Brott, G. J. del Zoppo, A. Furlan, L. B. Goldstein, R. L. Grubb, R. Higashida, C. Kidwell, T. G. Kwiatkowski, et al. Guidelines for the Early Management of Patients With Ischemic Stroke: A Scientific Statement From the Stroke Council of the American Stroke Association Stroke, April 1, 2003; 34(4): 1056 - 1083. [Full Text] [PDF]
|
|
|
|
|
|
S.E. Lamb, L. Ferrucci, S. Volapto, L.P. Fried, J.M. Guralnik, and Y. Gustafson Risk Factors for Falling in Home-Dwelling Older Women With Stroke: The Women's Health and Aging Study * Editorial Comment Stroke, February 1, 2003; 34(2): 494 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Jorgensen, T. Engstad, and B. K. Jacobsen Higher Incidence of Falls in Long-Term Stroke Survivors Than in Population Controls: Depressive Symptoms Predict Falls After Stroke Stroke, February 1, 2002; 33(2): 542 - 547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ugur, D. Gucuyener, N. Uzuner, S. Ozkan, and G. Ozdemir Characteristics of falling in patients with stroke J. Neurol. Neurosurg. Psychiatry, November 1, 2000; 69(5): 649 - 651. [Abstract] [Full Text] [PDF]
|
|