Incidence and Risk Factors of Poststroke Falls After Discharge From Inpatient Rehabilitation

ObjectiveTo investigate the incidence of falls and risk factors for falls in persons who had a stroke.DesignTelephone survey.SettingTertiary university hospital.Patients and MethodsPatients who had a stroke and were admitted to the rehabilitation unit between April 2006 and July 2008 were listed and contacted by telephone from February 2009 to August 2009.Main Outcome MeasurementsInformation obtained from the interviews, which were performed 20 ± 8 months after discharge from inpatient rehabilitation, included demographic data, information about falls, and current ambulatory function. After the telephone interview, medical records of participants during admission were reviewed.ResultsOf the 404 enrolled patients, 330 were included in the analysis. Of the 330 patients, 62 (19%) had a history of a fall after stroke onset. Of 222 ambulatory patients, 51 patients (23%) fell. Falls frequently occurred in winter, and most falls occurred indoors (70%). Twenty-nine percent of patients experienced repeated falls. About half of those who fell were injured, and 11% sustained fractures. Patients who had a stroke and had severe deficits showed a lower probability of poststroke falls. In a subgroup analysis of patients with ambulatory capacity, left-sided hemiplegia/hemiparesis was associated with an increased risk of falls.ConclusionsThis study reveals a high incidence of poststroke falls after discharge from inpatient rehabilitation. More caution should be taken for patients with ambulatory ability and left hemiplegia/hemiparesis because they are more vulnerable to falls after a stroke. An increased prevalence of fear of falling in people who fell suggests that an appropriate intervention to reduce fear of falling should be provided to patients who have had a stroke.