Abstract WP197: Recurrent Falls After Stroke: A One-Year Follow-Up of the Fall Study of Gothenburg

Abstract

Introduction: It is important to early after stroke identify those individuals at risk of falling and the key determinants of falling after discharge from the hospital, as that knowledge may offer possibilities for early preventive actions. The aim was to investigate the occurrence of at least two falls within the first year after stroke onset after discharge from a stroke unit, and to identify factors in the acute phase after stroke that predict these recurrent falls. Subjects: A total of 490 consecutive individuals with acute stroke, median aged 77 (IQR 67-84) years, of whom 248 (50.6%) were men. Methods: The dependent variable was recurrent falls within the first year after stroke onset after discharge from a stroke unit. Fall data was collected at six and 12 months after stroke onset using a standardized questionnaire. The independent baseline variables were related to function, activity, participation, environmental factors and personal factors and assessed within four days after admission to the stroke unit. The association between baseline variables and recurrent falls was examined using univariable and multivariable logistic regression analyses. Results: Within six and 12 months after stroke onset, 67 of 376 respondents (18%) and 80 of 348 respondents (23%), respectively, had experienced recurrent falls after discharge. Poor postural control, assessed using the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS), (SwePASS score ≤ 24) [odds ratio (OR) 4.23, 95% confidence interval (CI) 1.99-9.03, p=0.0002]; moderate postural control (SwePASS score 25-30) [OR 2.75, 95% CI 1.34-5.64, p=0.0057] and use of a walking aid [OR 2.05, 95% CI 1.16-3.60, p=0.013] were independent early predictors of recurrent falls after discharge within the first 12 months after stroke onset. In addition to these determinants, also fall in hospital [OR 2.48, 95% CI 1.16-5.31, p=0.019] was a predictor of recurrent falls during the first six months. Conclusion: Recurrent falls after discharge from a stroke unit within the first year after stroke onset were experienced by nearly one-quarter of the individuals and predicted by poor and moderate postural control and the use of a walking aid during the acute phase after a stroke.