Tutuarima J A, van der Meulen J H, de Haan R J, van Straten A, Limburg M
Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.
Stroke. 1997 Feb;28(2):297-301. doi: 10.1161/01.str.28.2.297.
Patients with stroke are at a high risk for falling. We assessed the fall incidence and risk factors for patients hospitalized as the result of an acute stroke.
We studied a cohort of 720 stroke patients from 23 hospitals in The Netherlands. The data were abstracted from the medical and nursing records.
We studied 346 women and 374 men with a median age of 75 years; 77% of the patients had had a cerebral infarct, 17% had had a hemorrhage, and 6% had had an undefined stroke. We recorded 104 patients (14%) who fell at least once; there were a total of 173 falls. The incidence of falls was 8.9/1000 patients per day. The daily incidence was 6.2/1000 patients for first falls and 17.9/1000 patients for second falls. Heart disease (relative risk [RR], 1.6; 95% confidence interval [CI], 1.0 to 2.4), mental decline (RR, 1.6; 95% CI, 1.0 to 2.4), and urinary incontinence (RR, 2.3; 95% CI, 1.3 to 4.1) were incremental risk factors for first falls, whereas the use of major psychotropic drugs lowered the fall risk (RR, 0.5; 95% CI, 0.3 to 0.8). The fall RR for patients with one previous fall was 2.2 (95% CI, 1.5 to 3.2), adjusted for the other risk factors. Most falls occurred during the day. Approximately 25% of the falls caused slight-to-severe injury, whereas three falls (2%) led to hip fractures.
Stroke patients have at risk of falling. The identification of patients at risk may be a first step toward the implementation of fall-prevention measures for these patients.
中风患者跌倒风险很高。我们评估了因急性中风住院患者的跌倒发生率及风险因素。
我们研究了来自荷兰23家医院的720名中风患者队列。数据从医疗和护理记录中提取。
我们研究了346名女性和374名男性，中位年龄为75岁；77%的患者患有脑梗死，17%患有出血性中风，6%患有不明类型中风。我们记录到104名患者（14%）至少跌倒过一次；总共发生了173次跌倒。跌倒发生率为每1000名患者每天8.9次。首次跌倒的每日发生率为每1000名患者6.2次，再次跌倒的每日发生率为每1000名患者17.9次。心脏病（相对风险[RR]，1.6；95%置信区间[CI]，1.0至2.4）、智力衰退（RR，1.6；95%CI，1.0至2.4）和尿失禁（RR，2.3；95%CI，1.3至4.1）是首次跌倒的递增风险因素，而使用主要精神药物可降低跌倒风险（RR，0.5；95%CI，0.3至0.8）。在调整其他风险因素后，有过一次跌倒史的患者跌倒RR为2.2（95%CI，1.5至3.2）。大多数跌倒发生在白天。约25%的跌倒造成了轻度至重度损伤，而三次跌倒（2%）导致了髋部骨折。
中风患者有跌倒风险。识别有风险的患者可能是对这些患者实施预防跌倒措施的第一步。
