Frequency, features, and factors for falls in a group of subacute stroke patients hospitalized for rehabilitation in Istanbul

Abstract

Falling is a major complication seen in stroke patients. The purpose of this study was to investigate the frequency, features, and factors for falls affecting subacute stroke patients hospitalized for rehabilitation. Ninety-nine subacute stroke patients, hospitalized for rehabilitation were evaluated prospectively in this study. All patients were evaluated using the functional independence measurement (FIM), the Barthel index (BI), the Berg balance scale (BBS), the mini mental state examination (MMSE), the hospital anxiety depression scale (HADS), and the Downton index (DI), performed by the same physician. Proximal femur bone mineral density (BMD) measurements were performed using the dual-energy X-ray absorbtiometry (DXA). During the period of hospitalization, 17 patients (17.2%) reported falling once. The calculated incidence rate for falls was 6.3/1000 hospital days (95% confidence interval, CI = 3.7-10.1). Furthermore, 41% of the falls occurred in patients' rooms, 82% between the hours 06:00- 20:00, 47% while walking and 65% on the side affected from the stroke. Despite the fact that 30% of the patients had osteoporosis, no fractures were observed after these falls, 88% had only soft tissue injury. Overall, 88% of the patients reported they had a fear for falling. Admission DI scores were significantly lower in the group of patients with no falls compared to the group with falls (p < 0.05). Falls occurred most frequently during daytime, while subacute stroke patients were walking. DI is useful in stroke patients that are to be hospitalized for rehabilitation and accordingly, preventive action taken on those patients with a high risk for falls. (C) 2010 Elsevier Ireland Ltd. All rights reserved.