E L Callaly1, D Ni Chroinin1, N Hannon1, O Sheehan1, M Marnane1, A Merwick1, L A Kelly1, G Horgan1, E Williams1, D Harris1, D Williams2, A Moore3, E Dolan4, S Murphy5, P J Kelly1, J Duggan1, L Kyne1. 1. Neurovascular Clinical Science Unit, Catherine McAuley Research Centre, Mater Misericordiae University Hospital, University College Dublin at Dublin Academic Medical Centre, Dublin 7, Ireland. 2. Beaumont Hospital, Dublin, Ireland Royal College of Surgeons, Dublin, Ireland. 3. Beaumont Hospital, Dublin, Ireland. 4. Connolly Hospital, Dublin, Ireland. 5. Neurovascular Clinical Science Unit, Catherine McAuley Research Centre, Mater Misericordiae University Hospital, University College Dublin at Dublin Academic Medical Centre, Dublin 7, Ireland Royal College of Surgeons, Dublin, Ireland.
Abstract
BACKGROUND: Stroke patients are at increased risk of falls and fractures. The aim of this study was to determine the rate, predictors and consequences of falls within 2 years after stroke in a prospective population-based study in North Dublin, Ireland. DESIGN: Prospective population-based cohort study. SUBJECTS: 567 adults aged >18 years from the North Dublin Population Stroke Study. METHODS: Participants were enrolled from an Irish urban population of 294,592 individuals, according to recommended criteria. Patients were followed for 2 years. Outcome measures included death, modified Rankin Scale (mRS), fall and fracture rate. RESULTS: At 2 years, 23.5% (124/522) had fallen at least once since their stroke, 14.2% (74/522) had 2 or more falls and 5.4% (28/522) had a fracture. Of 332 survivors at 2 years, 107 (32.2%) had fallen, of whom 60.7% (65/107) had 2 or more falls and 23.4% (25/107) had fractured. In a multivariable model controlling for age and gender, independent risk factors for falling within the first 2 years of stroke included use of alpha-blocker medications for treatment of hypertension (P = 0.02). When mobility measured at Day 90 was included in the model, patients who were mobility impaired (mRS 2-3) were at the highest risk of falling within 2 years of stroke [odds ratio (OR) 2.30, P = 0.003] and those functionally dependent (mRS 4-5) displayed intermediate risk (OR 2.02, P = 0.03) when compared with independently mobile patients. CONCLUSION: Greater attention to falls risk, fall prevention strategies and bone health in the stroke population are required.
BACKGROUND:Strokepatients are at increased risk of falls and fractures. The aim of this study was to determine the rate, predictors and consequences of falls within 2 years after stroke in a prospective population-based study in North Dublin, Ireland. DESIGN: Prospective population-based cohort study. SUBJECTS: 567 adults aged >18 years from the North Dublin Population Stroke Study. METHODS:Participants were enrolled from an Irish urban population of 294,592 individuals, according to recommended criteria. Patients were followed for 2 years. Outcome measures included death, modified Rankin Scale (mRS), fall and fracture rate. RESULTS: At 2 years, 23.5% (124/522) had fallen at least once since their stroke, 14.2% (74/522) had 2 or more falls and 5.4% (28/522) had a fracture. Of 332 survivors at 2 years, 107 (32.2%) had fallen, of whom 60.7% (65/107) had 2 or more falls and 23.4% (25/107) had fractured. In a multivariable model controlling for age and gender, independent risk factors for falling within the first 2 years of stroke included use of alpha-blocker medications for treatment of hypertension (P = 0.02). When mobility measured at Day 90 was included in the model, patients who were mobility impaired (mRS 2-3) were at the highest risk of falling within 2 years of stroke [odds ratio (OR) 2.30, P = 0.003] and those functionally dependent (mRS 4-5) displayed intermediate risk (OR 2.02, P = 0.03) when compared with independently mobile patients. CONCLUSION: Greater attention to falls risk, fall prevention strategies and bone health in the stroke population are required.
Authors: Moira K Kapral; Jiming Fang; Shabbir M H Alibhai; Peter Cram; Angela M Cheung; Leanne K Casaubon; Marla Prager; Melissa Stamplecoski; Brennan Rashkovan; Peter C Austin Journal: Neurology Date: 2016-11-23 Impact factor: 9.910
Authors: Mary E Walsh; Rose Galvin; David Jp Williams; Joseph A Harbison; Sean Murphy; Ronan Collins; Dominick Jh McCabe; Morgan Crowe; N Frances Horgan Journal: Eur Stroke J Date: 2018-03-16
Authors: Wycliffe E Wei; Deirdre A De Silva; Hui Meng Chang; Jiali Yao; David B Matchar; Sherry H Y Young; Siew Ju See; Gek Hsiang Lim; Ting Hway Wong; Narayanaswamy Venketasubramanian Journal: BMC Geriatr Date: 2019-12-26 Impact factor: 3.921