Epidemiology of falls among stroke patients hospitalized in a rehabilitation unit: A three year survey

Background: Falls are major complications in inpatient stroke rehabilitation. The early identification of those at risk is an important issue in preventive strategies. Aims: The study aimed to assess the risk factors for falls for patients hospitalized in a rehabilitation unit as a result of an acute stroke. Methods: We studied a cohort of 36 falls in 25 patients during the years 2000-2002. The questionnaire on each patient included general and medical information and the description of the event. Results: Eighteen patients fell once, five patients fell twice and two patients fell four times. In 89% of the falls, the patients were treated by tranquillizers, hypoglycemic, hypotensive or neuroleptic drugs. Most of the falls occurred in patients who suffered from hypotonus (72%), paralysis (58%) and hypoesthesia (52%) in the involved lower limb. A total of 67% of the falls occurred in males, 53% in patients over 65 years old, 47% during the first month after stroke and 36% in the second month. It was found that 78% of the falls happened during daytime and 64% took place in the patient's room. Communication disorders (28%), visuospatial agnosia (25%) and hemianopia (24%) were incremental risk factors for falls. Conclusion: Stroke is associated with a risk of falling during the rehabilitation period. The identification of patients at risk may be a first step toward the implementation of fall-prevention measures for these patients.