Skip to main content
Erschienen in: Neurological Sciences 9/2020

07.04.2020 | Original Article

Clinical features of fallers among inpatient subacute stroke: an observational cohort study

verfasst von: Giovanni Morone, Alex Martino Cinnera, Teresa Paolucci, Henson Dianne Reyes Beatriz, Stefano Paolucci, Marco Iosa

Erschienen in: Neurological Sciences | Ausgabe 9/2020

Einloggen, um Zugang zu erhalten

Abstract

Background and purpose

The aim of this study is to observe the differences between fallers, common fallers, and non-fallers in stroke patients compared with the global ability in a rehabilitation setting.

Materials and methods

An observational and prospective study has been carried out. A total of 476 subacute stroke patients have been observed. The main outcome measures were assessed using the Canadian Neurological Scale (CNS), Barthel Index (BI), Functional Ambulatory Category (FAC), and Trunk Control Test (TCT) at admission to the rehabilitation unit and after 90 days of the rehabilitation treatment (nearly 3 h for day for 5 days for week) at the discharge with intermediate evaluations after the first and second months.

Results

Out of 397 patients, 109 reported 1 or more falls (27.5%), of whom 67 fell 1 time (fallers) in the hospital (16.9%) and 42 fell 2 or more times (common fallers) (10.6%). For fallers, BI and FAC scores had a significant effect (p = 0.003 for both). Common fallers had statistically significant differences in BI (p = 0.002), FAC (p = 0.012), and TCT scores (0.023) compared with non-fallers.

Conclusions

The severity of stroke may directly increase the risk of fall, and also indirectly, lengthening the hospitalization. Our study seems to suggest that patients with BI scores of between 21 and 30 on admission are more prone to fall in the first period of hospitalization, whereas in the second month, those with scores of between 11 and 20 on admission have a higher risk of falls. In the third month, patients with BI scores below 10 on admission are more susceptible to falls.
Literatur
1.
Zurück zum Zitat Teasell R, McRae M, Foley N, Bhardwaj A (2002) The incidence and consequences of falls in stroke patients during inpatient rehabilitation: factors associated with high risk. Arch Phys Med Rehabil 83(3):329–333PubMedCrossRef Teasell R, McRae M, Foley N, Bhardwaj A (2002) The incidence and consequences of falls in stroke patients during inpatient rehabilitation: factors associated with high risk. Arch Phys Med Rehabil 83(3):329–333PubMedCrossRef
2.
Zurück zum Zitat Divani AA, Vazquez G, Barrett AM, Asadollahi M, Luft AR (2009) Risk factors associated with injury attributable to falling among elderly population with history of stroke. Stroke. 40(10):3286–3292PubMedPubMedCentralCrossRef Divani AA, Vazquez G, Barrett AM, Asadollahi M, Luft AR (2009) Risk factors associated with injury attributable to falling among elderly population with history of stroke. Stroke. 40(10):3286–3292PubMedPubMedCentralCrossRef
3.
Zurück zum Zitat Verheyden GS, Weerdesteyn V, Pickering RM et al (2013) Interventions for preventing falls in people after stroke. Cochrane Database Syst Rev 5:CD008728 Verheyden GS, Weerdesteyn V, Pickering RM et al (2013) Interventions for preventing falls in people after stroke. Cochrane Database Syst Rev 5:CD008728
4.
Zurück zum Zitat Ash KL, MacLeod P, Clark L (1998) A case control study of falls in the hospital setting. J Gerontol Nurs 24(12):7–15PubMedCrossRef Ash KL, MacLeod P, Clark L (1998) A case control study of falls in the hospital setting. J Gerontol Nurs 24(12):7–15PubMedCrossRef
5.
Zurück zum Zitat Saverino E, Benevolo M, Ottonello E, Zsirai P (2006) Sessarego. Falls in rehabilitation setting; functional independence and fall risk. EURA MEDICOPYHS 42(3):179–184 Saverino E, Benevolo M, Ottonello E, Zsirai P (2006) Sessarego. Falls in rehabilitation setting; functional independence and fall risk. EURA MEDICOPYHS 42(3):179–184
6.
Zurück zum Zitat Campbell GB, Matthews JT (2010) An integrative review of factors associated with falls during post-stroke rehabilitation. J Nurs Scholarsh 42(4):395–404PubMedPubMedCentralCrossRef Campbell GB, Matthews JT (2010) An integrative review of factors associated with falls during post-stroke rehabilitation. J Nurs Scholarsh 42(4):395–404PubMedPubMedCentralCrossRef
7.
Zurück zum Zitat Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C (2000) Medical complications after stroke. Stroke. 31(6):1223–1229PubMedCrossRef Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C (2000) Medical complications after stroke. Stroke. 31(6):1223–1229PubMedCrossRef
8.
Zurück zum Zitat Oliver D, Daly F, Martin FC, McMurdo ME (2004) Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review. Age Ageing 33(2):122–130PubMedCrossRef Oliver D, Daly F, Martin FC, McMurdo ME (2004) Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review. Age Ageing 33(2):122–130PubMedCrossRef
9.
Zurück zum Zitat Damián J, Pastor-Barriuso R, Valderrama-Gama E, de Pedro-Cuesta J (2013) Factors associated with falls among older adults living in institutions. BMC Geriatr 13:6PubMedPubMedCentralCrossRef Damián J, Pastor-Barriuso R, Valderrama-Gama E, de Pedro-Cuesta J (2013) Factors associated with falls among older adults living in institutions. BMC Geriatr 13:6PubMedPubMedCentralCrossRef
10.
Zurück zum Zitat Tsur A, Segal Z (2010) Falls in stroke patients: risk factors and risk management. Isr Med Assoc J 12(4):216–219PubMed Tsur A, Segal Z (2010) Falls in stroke patients: risk factors and risk management. Isr Med Assoc J 12(4):216–219PubMed
11.
Zurück zum Zitat Morone G, Iosa M, Pratesi L, Paolucci S (2014) Can overestimation of walking ability increase the risk of falls in people in the subacute stage after stroke on their return home? Gait Posture 39(3):965–970PubMedCrossRef Morone G, Iosa M, Pratesi L, Paolucci S (2014) Can overestimation of walking ability increase the risk of falls in people in the subacute stage after stroke on their return home? Gait Posture 39(3):965–970PubMedCrossRef
12.
Zurück zum Zitat Mackintosh SF, Hill KD, Dodd KJ, Goldie PA, Culham EG (2006) Balance score and a history of falls in hospital predict recurrent falls in the 6 months following stroke rehabilitation. Arch Phys Med Rehabil 87(12):1583–1589PubMedCrossRef Mackintosh SF, Hill KD, Dodd KJ, Goldie PA, Culham EG (2006) Balance score and a history of falls in hospital predict recurrent falls in the 6 months following stroke rehabilitation. Arch Phys Med Rehabil 87(12):1583–1589PubMedCrossRef
14.
Zurück zum Zitat Nevitt MC, Cummings SR (1991) Risk factors for injurious falls: a prospective study. J Gerontol 46(5):M164–M170PubMedCrossRef Nevitt MC, Cummings SR (1991) Risk factors for injurious falls: a prospective study. J Gerontol 46(5):M164–M170PubMedCrossRef
15.
Zurück zum Zitat Kellogg International Work Group on the Prevention of Falls by the Elderly (1987) The prevention of falls in later life. Dan Med Bull 34(Suppl. 4):1–24 Kellogg International Work Group on the Prevention of Falls by the Elderly (1987) The prevention of falls in later life. Dan Med Bull 34(Suppl. 4):1–24
16.
Zurück zum Zitat Zecevic AA, Salmoni AW, Speechley M, Vandervoort AA (2006 Jun) Defining a fall and reasons for falling: comparisons among the views of seniors, health care providers, and the research literature. Gerontologist. 46(3):367–376PubMedCrossRef Zecevic AA, Salmoni AW, Speechley M, Vandervoort AA (2006 Jun) Defining a fall and reasons for falling: comparisons among the views of seniors, health care providers, and the research literature. Gerontologist. 46(3):367–376PubMedCrossRef
17.
Zurück zum Zitat Paolucci S, Bragoni M, Coiro P, de Angelis D, Fusco FR, Morelli D, Venturiero V, Pratesi L (2008) Quantification of the probability of reaching mobility independence at discharge from a rehabilitation hospital in nonwalking early ischemic stroke patients: a multivariate study. Cerebrovasc Dis 26(1):16–22PubMedCrossRef Paolucci S, Bragoni M, Coiro P, de Angelis D, Fusco FR, Morelli D, Venturiero V, Pratesi L (2008) Quantification of the probability of reaching mobility independence at discharge from a rehabilitation hospital in nonwalking early ischemic stroke patients: a multivariate study. Cerebrovasc Dis 26(1):16–22PubMedCrossRef
18.
Zurück zum Zitat Shah S, Vanclay F, Cooper B (1990) Efficiency, effectiveness, and duration of stroke rehabilitation. Stroke. 21(2):241–246PubMedCrossRef Shah S, Vanclay F, Cooper B (1990) Efficiency, effectiveness, and duration of stroke rehabilitation. Stroke. 21(2):241–246PubMedCrossRef
19.
Zurück zum Zitat Blennerhassett JM, Dite W, Ramage ER, Richmond ME (2012) Changes in balance and walking from stroke rehabilitation to the community: a follow-up observational study. Arch Phys Med Rehabil 93(10):1782–1787PubMedCrossRef Blennerhassett JM, Dite W, Ramage ER, Richmond ME (2012) Changes in balance and walking from stroke rehabilitation to the community: a follow-up observational study. Arch Phys Med Rehabil 93(10):1782–1787PubMedCrossRef
20.
Zurück zum Zitat Oliver D, Hopper A, Seed P (2000) Do hospital fall prevention programs work? A systematic review. J Am Geriatr Soc 48(12):1679–1689PubMedCrossRef Oliver D, Hopper A, Seed P (2000) Do hospital fall prevention programs work? A systematic review. J Am Geriatr Soc 48(12):1679–1689PubMedCrossRef
22.
Zurück zum Zitat Wong JS, Brooks D, Mansfield A (2016) Do falls experienced during inpatient stroke rehabilitation affect length of stay, functional status, and discharge destination? Arch Phys Med Rehabil 97(4):561–566PubMedCrossRef Wong JS, Brooks D, Mansfield A (2016) Do falls experienced during inpatient stroke rehabilitation affect length of stay, functional status, and discharge destination? Arch Phys Med Rehabil 97(4):561–566PubMedCrossRef
24.
Zurück zum Zitat Duffy L, Gajree S, Langhorne P, Stott DJ, Quinn TJ (2013) Reliability (inter-rater agreement) of the Barthel Index for assessment of stroke survivors: systematic review and meta-analysis. Stroke. 44(2):462–468PubMedCrossRef Duffy L, Gajree S, Langhorne P, Stott DJ, Quinn TJ (2013) Reliability (inter-rater agreement) of the Barthel Index for assessment of stroke survivors: systematic review and meta-analysis. Stroke. 44(2):462–468PubMedCrossRef
Metadaten
Titel
Clinical features of fallers among inpatient subacute stroke: an observational cohort study
verfasst von
Giovanni Morone
Alex Martino Cinnera
Teresa Paolucci
Henson Dianne Reyes Beatriz
Stefano Paolucci
Marco Iosa
Publikationsdatum
07.04.2020
Verlag
Springer International Publishing
Erschienen in
Neurological Sciences / Ausgabe 9/2020
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-020-04352-2

Weitere Artikel der Ausgabe 9/2020

Neurological Sciences 9/2020 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.