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Clinical features of fallers among inpatient subacute stroke: an observational cohort study

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Abstract

Background and purpose

The aim of this study is to observe the differences between fallers, common fallers, and non-fallers in stroke patients compared with the global ability in a rehabilitation setting.

Materials and methods

An observational and prospective study has been carried out. A total of 476 subacute stroke patients have been observed. The main outcome measures were assessed using the Canadian Neurological Scale (CNS), Barthel Index (BI), Functional Ambulatory Category (FAC), and Trunk Control Test (TCT) at admission to the rehabilitation unit and after 90 days of the rehabilitation treatment (nearly 3 h for day for 5 days for week) at the discharge with intermediate evaluations after the first and second months.

Results

Out of 397 patients, 109 reported 1 or more falls (27.5%), of whom 67 fell 1 time (fallers) in the hospital (16.9%) and 42 fell 2 or more times (common fallers) (10.6%). For fallers, BI and FAC scores had a significant effect (p = 0.003 for both). Common fallers had statistically significant differences in BI (p = 0.002), FAC (p = 0.012), and TCT scores (0.023) compared with non-fallers.

Conclusions

The severity of stroke may directly increase the risk of fall, and also indirectly, lengthening the hospitalization. Our study seems to suggest that patients with BI scores of between 21 and 30 on admission are more prone to fall in the first period of hospitalization, whereas in the second month, those with scores of between 11 and 20 on admission have a higher risk of falls. In the third month, patients with BI scores below 10 on admission are more susceptible to falls.

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Funding

This work is supported by the Italian Ministry of Health with the Grant Number RC2013G and by IRCCS Santa Lucia foundation.

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Authors and Affiliations

  1. Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy

    Giovanni Morone, Stefano Paolucci & Marco Iosa

  2. Neurorehabilitation Unit F, IRCCS Santa Lucia Foundation, via Ardeatina 354, 00142, Roma, Italy

    Alex Martino Cinnera & Stefano Paolucci

  3. Complex Unit of Physical Medicine and Rehabilitation, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy

    Teresa Paolucci

  4. Neurorehabilitation Unit B, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy

    Henson Dianne Reyes Beatriz

Authors
  1. Giovanni Morone
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  2. Alex Martino Cinnera
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  3. Teresa Paolucci
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  4. Henson Dianne Reyes Beatriz
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  5. Stefano Paolucci
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  6. Marco Iosa
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Corresponding author

Correspondence to Alex Martino Cinnera.

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Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

The protocol was approved by the local independent ethics committee, and all participants provided written informed consent.

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The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Morone, G., Martino Cinnera, A., Paolucci, T. et al. Clinical features of fallers among inpatient subacute stroke: an observational cohort study. Neurol Sci 41, 2599–2604 (2020). https://doi.org/10.1007/s10072-020-04352-2

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  • DOI: https://doi.org/10.1007/s10072-020-04352-2

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