Citation

Walsh ME, Galvin R, Williams DJ, Harbison JA, Murphy S, Collins R, McCabe DJ, Crowe M, Horgan NF. Eur. Stroke J. 2018; 3(3): 246-253.

Affiliation

School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.

Copyright

(Copyright © 2018, SAGE Publications)

DOI

10.1177/2396987318764961

PMID

31008355

PMCID

PMC6453197

Abstract

INTRODUCTION: Falls are common post-stroke adverse events. This study aimed to describe the first-year falls incidence, circumstances and consequences among persons discharged home after stroke in Ireland, and to examine the association between potential risk factors and recurrent falls.

PATIENTS AND METHODS: Patients with acute stroke and planned home-discharge were recruited consecutively from five hospitals. Variables recorded pre-discharge included: age, stroke severity, co-morbidities, fall history, prescribed medications, hemi-neglect, cognition and functional independence (Barthel index). Falls were recorded with monthly diaries, and 6 and 12-month interviews. The association of pre-discharge factors with recurrent falls (>1 fall) was examined using univariable logistic regression.

RESULTS: A total of 128 participants (mean age = 68.6, SD = 13.3) were recruited; 110 completed the 12-month follow-up. The first-year falls incidence was 44.5% (95% CI = 35.1-53.6) with 25.6% falling repeatedly (95% CI = 18.5-34.4). Fallers experienced 1-18 falls (median = 2) and five reported fractures; 47% of fallers experienced at least one fall outdoors. Only 10% of recurrent fallers had bone health medication prescribed at discharge. Lower Barthel index scores (<75/100, RR = 4.38, 1.64-11.72) and psychotropic medication prescription (RR = 2.10, 1.13-3.91) were associated with recurrent falls.

DISCUSSION: This study presents prospectively collected information about falls circumstances. It was not powered for multivariable analysis of risk factors.

CONCLUSION: One-quarter of stroke survivors discharged to the community fall repeatedly and mostly indoors in the first year. Specific attention may be required for individuals with poor functional independence or those on psychotropic medication. Future falls-management research in this population should explore falls in younger individuals, outdoor as well as indoor falls and post-stroke bone health status.

Language: en

Keywords

Accidental falls; fractures; rehabilitation; stroke