Health Services Research and Development Center on Implementing Evidence-Based Practice, Roudebush VA Medical Center, Indianapolis, IN 46202-5199, USA.
Neuroepidemiology. 2010;34(3):158-62. doi: 10.1159/000279332. Epub 2010 Feb 2.
Falls are common after stroke. Simple, clinically practical tools are needed to easily identify patients with stroke who are at risk of falls. The objective of this study was to identify the factors associated with increased fall risk in a poststroke population.
We assessed factors associated with fall risk among poststroke patients. Fall risk was determined through a history of falls, physical examination, observations of transfers, gait, balance, strength, range of motion, and use of assistive devices. Stroke severity was evaluated using the NIH Stroke Scale (NIHSS); mild or moderate-severe stroke was defined as a NIHSS score of <4 or > or = 4, respectively.
Among 52 poststroke patients, 26 (50%) were considered at risk of falls. Patients at risk of falls compared with those without fall risk were more likely to have greater stroke severity, decreased functional status, and to be more dependent in activities of daily living. Increased stroke severity was independently associated with higher fall risk (NIHSS > or = 4: OR = 5.73; 95% CI: 1.645-19.94).
Poststroke patients at risk of falls can be identified by an NIHSS score of > or = 4. Clinicians should screen patients for fall risk so that fall prevention strategies can be instituted.
中风后常发生跌倒。需要简单、临床实用的工具来方便识别有跌倒风险的中风患者。本研究的目的是确定与中风后人群跌倒风险增加相关的因素。
我们评估了中风后患者跌倒风险的相关因素。通过病史、体检、转移观察、步态、平衡、力量、活动度和辅助器具使用情况来确定跌倒风险。使用 NIH 中风量表（NIHSS）评估中风严重程度；NIHSS 评分<4 分为轻度，≥4 分为中重度。
在 52 名中风后患者中，26 名（50%）被认为有跌倒风险。与无跌倒风险的患者相比，有跌倒风险的患者更有可能出现更严重的中风、功能状态下降，并且日常生活活动更依赖他人。中风严重程度增加与更高的跌倒风险独立相关（NIHSS≥4：OR=5.73；95%CI：1.645-19.94）。
NIHSS 评分≥4 分的中风后患者有跌倒风险。临床医生应筛查患者的跌倒风险，以便实施跌倒预防策略。
