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Incidence and consequences offalls due to stroke: a systematic inquiry

^a Department of Health Care for the Elderly, Saint Luke's Hospital, Bradford BD5 0NA

Correspondence to: Dr Forster.

Abstract

Objective: To undertake a systematic inquiry into the incidence and consequences of falls in a cohort of elderly patients with stroke after discharge from hospital.
Design: Administration of a questionnaire to patients and main carers at discharge from hospital and eight weeks and six months later.
Setting: Bradford Metropolitan District.
Subjects: 108 patients recruited to the Bradford community stroke trial. Patients were recruited to the trial if they were 60 years or over and resident at home with some residual disability.
Main outcome measures: Number of falls, motor club assessment, Barthel index, Frenchay activities index, and Nottingham health profile. Stress in carers was indicated by the general health questionnaire.
Results: Of 108 patients, 79 (73%) fell in the six months after discharge from hospital with a total of 270 falls reported. Patients who fell in hospital were significantly more likely to fall at least twice at home after discharge (x²=8.16; P=0.004). "Fallers" (two or more falls) were less socially active at six months and more had depressed mood. Carers of these patients were significantly more stressed at six months (53% v 18%; x²=8.5; P=0.003).
Conclusion: Stroke is associated with a risk of falling at home and affects the lives of patients with stroke and their carers. Falling and fear of falling is an important issue which needs to be dealt with by the multidisciplinary team.

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Key messages
-----------------------------------------------------
* Falls are common in patients discharged
home after stroke

* Major injury is rare

* Falling in hospital is a significant predictor
for falling at home

* Patients identified as being "at risk" should
be given advice and guidance by the multi-
disciplinary team before discharge

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Falls due to stroke

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