The Kunin-Lunenfeld Applied Research Unit Baycrest, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.
BMC Geriatr. 2009 Oct 14;9:46. doi: 10.1186/1471-2318-9-46.
Stroke victims are at relatively high risk for injurious falls. The purpose of this study was to document longitudinal fall patterns following inpatient rehabilitation for first-time stroke survivors.
Participants (n = 231) were recruited at the end of their rehab stay and interviewed monthly via telephone for 1 to 32 months regarding fall incidents. Analyses were conducted on: total reports of falls by month over time for first-time and repeat fallers, the incidence of falling in any given month; and factors differing between fallers and non fallers.
The largest percentage of participants (14%) reported falling in the first month post-discharge. After month five, less than 10% of the sample reported falling, bar months 15 (10.4%) and 23 (13.2%). From months one to nine, the percentage of those reporting one fall with and without a prior fall were similar. After month nine, the number of individuals who reported a single fall with a fall history was twice as high compared to those without a prior fall who reported falling. In both cases the percentages were small. A very small subset of the population emerged who fell multiple times each month, most of whom had a prior fall history. At least a third of the sample reported a loss of balance each month. Few factors differed significantly between fallers and non-fallers in months one to six.
Longitudinal data suggest that falls most likely linked to first time strokes occur in the first six months post discharge, particularly month one. Data routinely available at discharge does not distinguish fallers from non-fallers. Once a fall incident has occurred however, preventive intervention is warranted.
中风患者受伤性跌倒的风险相对较高。本研究的目的是记录首次中风幸存者住院康复后的纵向跌倒模式。
在康复结束时招募参与者(n=231),并通过电话每月对他们进行一次至 32 个月的访谈,以了解跌倒事件。对以下方面进行了分析:首次和重复跌倒者在每个月的跌倒总报告数,任何一个月的跌倒发生率;以及跌倒者和非跌倒者之间的差异因素。
最大比例的参与者(14%)报告在出院后第一个月跌倒。第五个月后,不到 10%的样本报告跌倒,除了 15 个月(10.4%)和 23 个月(13.2%)。从第一个月到第九个月,报告有一次跌倒和无一次跌倒的人数百分比相似。第九个月后,有跌倒史的报告单次跌倒的人数是没有跌倒史的报告跌倒人数的两倍。在这两种情况下,百分比都很小。每月多次跌倒的人群很少,其中大多数人有跌倒史。至少三分之一的样本每月报告一次失去平衡。在第一个到第六个月,跌倒者和非跌倒者之间很少有因素有显著差异。
纵向数据表明,与首次中风相关的跌倒最有可能发生在出院后的前六个月,特别是第一个月。出院时常规获得的数据并不能区分跌倒者和非跌倒者。然而,一旦发生跌倒事件,就需要进行预防干预。