Article

OBJECTIVE: To determine predictors of falls in stroke patients in the first 6
months after a baseline evaluation before their discharge from inpatient rehabilitation. DESIGN: Prospective cohort study. SETTING: Rehabilitation
hospital, then home. PARTICIPANTS: Consecutive stroke patients (N=66) were
followed at home after discharge from the rehabilitation hospital. INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURES: Fall occurrence within 6 months after a
baseline evaluation. All patients were assessed for baseline data during their
inpatient rehabilitation (1.5+/-1.2 wk before discharge). Data regarding
cerebrovascular accident (CVA) date, number of attacks, and brain imaging results
were obtained; motor function and balance impairment were examined by the
Fugl-Meyer Assessment Scale. The FIM and Functional Ambulation Category were also
used. Presence of urinary incontinence, drug use, fall history, postural
hypotension, neglect, cognitive status, poor vision, and hearing were evaluated.
Six months after the baseline evaluation, any fall occurrence was ascertained via
telephone calls to the caregivers of each patient. Multivariate logistic
regression analysis was used to identify risk factors. RESULTS: The mean age +/-
SD was 64+/-10 years. The median time elapsed since CVA at the time of admission
was 4 months. Twenty-four (36%) patients fell within the 6-month period. The fall
rate was significantly higher in patients with left (47%) versus right (21%)
hemispheric stroke. Left hemispheric lesion (vs right) showed a 4 times greater
risk of fall within 6 months (odds ratio=4.093; 95% confidence interval,
1.082-15.482). There were no other significant differences between fallers and
nonfallers with respect to the other evaluated factors. CONCLUSIONS: Our results
suggest that the fall risk within 6 months after a baseline evaluation is greater
in patients with left hemispheric lesions versus those with right hemispheric lesions.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS