Department of Rehabilitation, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake, Aichi, Toyoake 470-1192, Japan.
Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan; Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan.
J Stroke Cerebrovasc Dis. 2022 Jan;31(1):106169. doi: 10.1016/j.jstrokecerebrovasdis.2021.106169. Epub 2021 Nov 1.
To examine the relationship between patients' transfer ability and fall risk in stroke patients during hospitalization.
We retrospectively enrolled 237 stroke patients who were transferred to a convalescent rehabilitation ward from acute wards in the same hospital. Using incident reports, we investigated their fall rates and activity status at the falls according to their transfer abilities, which were assessed with Functional Independence Measure (FIM) transfer scores. The bi-weekly time trend of fall rates in all patients and in three subgroups based on FIM transfer scores of 1-3, 4-5, and 6-7, and activity status at the falls, were investigated. In addition, changes of patients' transfer ability on admission, at the first fall, and at discharge were investigated among falling patients.
The fall rate was the greatest in patients with a FIM transfer score of 4 (14.3 times/1000 person-days). The majority of falls for patients with a FIM transfer score of 1 occurred at the activity status of "on the bed" and "sitting", while three quarters of patients with a FIM score of 7 had falls during "standing" and "walking". No longitudinal trend in fall rates was found overall; however, the fall rate trends differed depending on the FIM transfer score. The majority of the patients who fell required full assistance for transfers upon admission but required no assistance at discharge.
Fall risk differed among patients with various transfer abilities; the greatest risk was in those who needed minimal assistance for transfers.
研究住院脑卒中患者的转移能力与跌倒风险之间的关系。
我们回顾性纳入了 237 例从同一家医院的急性病房转至康复病房的脑卒中患者。通过事件报告，根据转移能力（采用功能独立性量表[FIM]的转移评分进行评估），调查了他们的跌倒发生率和跌倒时的活动状态。调查了所有患者以及 FIM 转移评分分别为 1-3、4-5 和 6-7 的三组患者的两周内跌倒发生率的时间趋势，以及跌倒时的活动状态。此外，还调查了跌倒患者入院时、首次跌倒时和出院时的转移能力变化。
FIM 转移评分为 4 分的患者跌倒发生率最高（14.3 次/1000人天）。FIM 转移评分为 1 分的患者大多数跌倒发生在“卧床”和“坐”的活动状态下，而 FIM 评分为 7 分的患者中有四分之三的跌倒发生在“站立”和“行走”期间。总体而言，未发现跌倒发生率的纵向趋势，但跌倒发生率趋势因 FIM 转移评分而异。大多数跌倒的患者入院时需要完全协助转移，但出院时无需协助。
具有不同转移能力的患者跌倒风险不同；需要最小协助进行转移的患者风险最大。
