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Falls and fractures 2 years after acute stroke: the North Dublin Population Stroke Study
E L Callaly1, D Ni Chroinin1, N Hannon1
1Neurovascular Clinical Science Unit, Catherine McAuley Research Centre, Mater Misericordiae University Hospital, University College Dublin at Dublin Academic Medical Centre, Dublin 7, Ireland.
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.
