Risk factors for falls of hospitalized stroke patients.
OBJECTIVE
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 at risk of falling. The identification of patients at risk may be a first step toward the implementation of fall-prevention measures for these patients.
Tutuarima
J A
JA
Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands. Tutuarima@amc.uva.nl
van der Meulen
J H
JH
de Haan
R J
RJ
van Straten
A
A
Limburg
M
M
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000534:rehabilitation; D015331:Cohort Studies; D015897:Comorbidity; D003221:Confusion / Q000150:complications; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications; D009426:Netherlands / Q000453:epidemiology; D010362:Patients' Rooms; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D016896:Treatment Outcome; D016138:Walking