2006 issue 4


Volume 15, issue 4

Original article

Patients ' falls in a neurological rehabilitation ward

1. Oddziału Rehabilitacji Neurologicznej II Kliniki Neurologicznej Instytutu Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2006; 15 (4): 223-233
Keywords: accidental falls, rehabilitation, stroke

Background. Neurological patients, especially stroke patients, are at a high risk for falls. The purpose of the study is to estimate the frequency, character and consequences offalls, as well as risk factors for falls in patients during inpatient neurological rehabilitation.

Methods. Participants in the study were 569 consecutive patients of the Neurological Rehabilitation Ward in Warsaw; in that number 65.7% stroke cases and 34.3% patients with other neurological conditions. Their routine medical records and nursing reports concerning falls were analysed.

Results. Out of 49 (8.6% of the sample) patients who suffered falls 39 (79.6%) were stroke cases. The total of 66 falls were recorded corresponding to the incidence rate of 4.23 falls per 1000patient-days (95% CI 3.21-5.25). Most falls (15, i.e. 22.7%o) occurred during transfers or position changing (14, or 21.2%). No injury was sustained in 40 (60%) falls, while 17 (25%) falls caused some and 3 (4.5%) - severe injury (fractures and wounds). Higher incidence offalls was significantly related to the diagnosis of stroke (RR = 2.2 95% CI 1.07-4.47), the presence of hemineglect (RR = 3.9 95% CI 2.09-9.44) and poor performance on the admission Activities of Daily Living (ADL) scores: Rankin >3 (RR = 4.0 95% CI 2.17-9.11) and score <14 on the Barthel Index (RR = 5.1 95% CI 2.39-13.7). As compared to non-fallers, fallers were older (p = .01) and stayed longer in rehabilitation (p = .003).

Conclusion. Stroke survivors were most prone to falls in this study. The problem needs further investigation.

Address for correspondence:
Dr Anna Czernuszenko, Oddział Rehabilitacji Neurologicznej II Kliniki Neurologicznej Instytutu Psychiatrii i Neurologii,
ul. Sobieskiego 9, 02-957 Warszawa, e-mail: beres@mp.pl