Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Fl, Gothenburg, Sweden.
Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital/Östra, Gothenburg, Region Västra Götaland, Sweden.
Sci Rep. 2021 Dec 15;11(1):24035. doi: 10.1038/s41598-021-03375-9.
We aimed to identify determinants in acute stroke that are associated with falls during the stroke unit stay. In order to enable individualized preventive actions, this knowledge is fundamental. Based on local and national quality register data on an unselected sample of 5065 stroke patients admitted to a stroke unit at a Swedish university hospital, univariable and multivariable logistic regression analyses were performed. The dependent variable was any fall during stroke unit stay. The independent variables related to function, activity, personal factors, time to assessment, comorbidities and treatments. Determinants of falls were: being male (odds ratio (OR) 2.25, 95% confidence interval (95% CI) 1.79-2.84), haemorrhagic stroke (OR 1.39, 95% CI 1.05-1.86), moderate stroke symptoms according to the National Institutes of Health Stroke Scale (NIHSS score 2-5 vs. NIHSS score 0-1) (OR 1.43, 95% CI 1.08-1.90), smoking (OR 1.70, 95% CI 1.29-2.25), impaired postural control in walking (OR 4.61, 95% CI 3.29-6.46), impaired postural control in standing (OR 1.60, 95% CI 1.25-2.05), stroke-related arm- and hand problems, OR 1.45, 95% CI 1.11-1.91), impaired cognition (OR 1.43, 95% CI 1.04-1.95), and urinary tract infection (OR 1.91, 95% CI 1.43-2.56). The findings from this study are useful in clinical practice and might help to improve patient safety after stroke.
我们旨在确定与卒中单元住院期间跌倒相关的急性卒中决定因素。为了能够采取个体化的预防措施,这方面的知识是至关重要的。基于瑞典一家大学医院卒中单元收治的 5065 名卒中患者的局部和国家质量登记数据,对 5065 名卒中患者进行了单变量和多变量逻辑回归分析。因变量为卒中单元住院期间的任何跌倒。自变量与功能、活动、个人因素、评估时间、合并症和治疗有关。跌倒的决定因素为:男性(优势比(OR)2.25,95%置信区间(95%CI)1.79-2.84)、出血性卒中(OR 1.39,95%CI 1.05-1.86)、根据美国国立卫生研究院卒中量表(NIHSS 评分 2-5 与 NIHSS 评分 0-1)的中度卒中症状(OR 1.43,95%CI 1.08-1.90)、吸烟(OR 1.70,95%CI 1.29-2.25)、行走时姿势控制受损(OR 4.61,95%CI 3.29-6.46)、站立时姿势控制受损(OR 1.60,95%CI 1.25-2.05)、与卒中相关的手臂和手部问题(OR 1.45,95%CI 1.11-1.91)、认知障碍(OR 1.43,95%CI 1.04-1.95)和尿路感染(OR 1.91,95%CI 1.43-2.56)。本研究的结果在临床实践中很有用,可能有助于提高卒中后的患者安全性。