title: Proposal for a New Predictive Scale for Recurrent Risk of Fall in a Cohort of Community-Dwelling Patients with Stroke.
abstract: OBJECTIVE
  This study aimed to determine risk factors related to the occurrence of falls in stroke patients and to propose a new predictive scale for falls.
  
  
  METHODS
  Demographic and clinical data were collected and the following scales were applied: Barthel Index, Timed Up and Go Test (TUG), and National Institutes of Health Stroke Scale (NIHSS). Subjects were followed prospectively for 2 years for the occurrence of recurrent (≥2) falls. Kaplan-Meier curves were constructed and univariable associations were tested using log-rank test. Two separate multivariable models were then used: the first used Cox proportional hazards regression and the second used Poisson regression. In each model, significant associations were considered present with a P value less than .05.
  
  
  RESULTS
  We evaluated 150 individuals and the final analysis included 131 patients; the average age of the patients was 55.8 ± 13 years, 52% were women, and the median NIHSS score was 2 (interquartile range = 1-5). Falls occurred in 17% of patients, with a median of 23 months of follow-up (interquartile range = 16-26 months). In the multivariable Cox regression model, only TUG quartile, female gender, and posterior circulation territory involvement remained significant predictors of recurrent falls. We used the predictors from the Cox regression model to propose a new recurrent fall risk scale. The area under the receiver operating characteristic curve was 73%, 95% confidence interval = 62%-83%, P = .001, with 81.3% sensitivity and 41.8% specificity.
  
  
  CONCLUSIONS
  The new predictive scale for recurrent risk (including TUG, posterior circulation territory involvement, and female gender) is presented as an instrument for monitoring the risk of recurrent falls.
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Department of Physical Therapy, Bahia School of Medicine and Public Health, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil. Electronic address: elen.neuro@gmail.com.
authors.forename: Elen Beatriz
authors.initials: EB
authors.lastname: Pinto
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Department of Physical Therapy, Bahia School of Medicine and Public Health, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Carla
authors.initials: C
authors.lastname: Nascimento
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Department of Physical Therapy, Bahia School of Medicine and Public Health, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Maiana
authors.initials: M
authors.lastname: Monteiro
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Department of Physical Therapy, Bahia School of Medicine and Public Health, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Mayra
authors.initials: M
authors.lastname: Castro
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Department of Physical Therapy, Bahia School of Medicine and Public Health, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Iara
authors.initials: I
authors.lastname: Maso
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Department of Physical Therapy, Bahia School of Medicine and Public Health, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Campos
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Camila
authors.initials: C
authors.lastname: Marinho
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Nestor J
authors.initials: NJ
authors.lastname: Barreto-Neto
authors.affiliation: Department of Internal Medicine and Diagnosis, Federal University of Bahia, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Antônio A
authors.initials: AA
authors.lastname: Lopes
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Pedro A P
authors.initials: PA
authors.lastname: Jesus
authors.affiliation: Stroke Clinic of the Federal University of Bahia, Brazil; Ambulatório de Doenças Cerebrovasculares, Hospital Universitário Prof. Edgard Santos-HUPES, Salvador, Brazil.
authors.forename: Jamary
authors.initials: J
authors.lastname: Oliveira-Filho
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D057187:Independent Living; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors
keywords: Stroke; TUG; fall predictors; recurrent fall