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急性脑卒中后卒中单元跌倒风险:哥德堡研究(FallsGOT)。

Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT).

机构信息

1 Rehabilitation Medicine, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

2 Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Clin Rehabil. 2018 Mar;32(3):398-409. doi: 10.1177/0269215517728325. Epub 2017 Sep 11.

Abstract

OBJECTIVE

This study aimed to investigate incidence of falls and different baseline variables and their association with falling during hospitalization in a stroke unit among patients with acute stroke.

DESIGN

Prospective observational study.

SETTING

A stroke unit at a university hospital.

SUBJECTS

A consecutive sample of stroke patients, out of which 504 were included, while 101 declined participation.

METHODS

The patients were assessed a mean of 1.7 days after admission and 3.8 days after stroke onset.

MAIN MEASURES

The primary end-point was any fall, from admission to the stroke unit to discharge. Factors associated with falling were analysed using univariable and multivariable Cox hazard regression analyses. Independent variables were related to function, activity and participation, as well as personal and environmental factors.

RESULTS

In total, 65 patients (13%) fell at least once. Factors statistically significantly associated with falling in the multivariable analysis were male sex (hazard ratio (HR): 1.88, 95% confidence interval (CI): 1.13-3.14, P = 0.015), use of a walking aid (HR: 2.11, 95% CI: 1.24-3.60, P = 0.006) and postural control as assessed with the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS). No association was found with age, cognition or stroke severity, the HR for low SwePASS scores (⩽24) was 9.33 (95% CI: 2.19-39.78, P = 0.003) and for medium SwePASS scores (25-30) was 6.34 (95% CI: 1.46-27.51, P = 0.014), compared with high SwePASS scores (⩾31).

CONCLUSION

Postural control, male sex and use of a walking aid are associated with falling during hospitalization after acute stroke.

摘要

目的

本研究旨在调查急性脑卒中患者在脑卒中单元住院期间的跌倒发生率以及不同的基线变量及其与跌倒的关系。

设计

前瞻性观察性研究。

地点

一所大学医院的脑卒中单元。

对象

连续入组的脑卒中患者,其中 504 例纳入研究,101 例患者拒绝参与。

方法

患者在入院后平均 1.7 天和卒中发病后 3.8 天进行评估。

主要观察指标

主要终点是从入住脑卒中单元到出院期间的任何跌倒。采用单变量和多变量 Cox 风险回归分析来分析与跌倒相关的因素。将与功能、活动和参与以及个人和环境因素相关的独立变量进行了分析。

结果

共有 65 例患者(13%)至少跌倒 1 次。多变量分析中与跌倒相关的统计学显著因素为男性(风险比(HR):1.88,95%置信区间(CI):1.13-3.14,P=0.015)、使用助行器(HR:2.11,95% CI:1.24-3.60,P=0.006)和改良版脑卒中患者姿势评估量表(SwePASS)评估的姿势控制。年龄、认知或卒中严重程度与跌倒无相关性,低 SwePASS 评分(⩽24)的 HR 为 9.33(95% CI:2.19-39.78,P=0.003),中 SwePASS 评分(25-30)的 HR 为 6.34(95% CI:1.46-27.51,P=0.014),均高于高 SwePASS 评分(⩾31)。

结论

急性脑卒中后住院期间的跌倒与姿势控制、男性和使用助行器有关。

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