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Factors affecting falls in spinal cord injured in-patients during rehabilitation, a retrospective matched pair
Fatma Kumbara1, Aslı Turan2, Berna Orhan2
1Ankara Bilkent City Hospital Physical Medicine and Rehabilitation, Ankara, Turkey. fatmakumbara@gmail.com.
Study Design:
Retrospective matched-pair case-control study.
Objectives:
The aim of this study was to investigate the risk factors associated with in-hospital falls among individuals with spinal cord injury (SCI) during rehabilitation, and to evaluate whether the presence of a caregiver was associated with fall risk.
Setting:
Rehabilitation unit, Ankara Bilkent City Hospital, Turkey.
Methods:
This retrospective matched case-control study included inpatients with traumatic and non-traumatic spinal cord injury (SCI) who underwent inpatient rehabilitation between January 2020 and December 2023. Patients who experienced at least one fall during the rehabilitation period were compared with non-falling patients matched for age, sex, neurological level, and functional status. Demographic and clinical variables, including the American Spinal Injury Association Impairment Scale (AIS), Walking Index for Spinal Cord Injury (WISCI), Spinal Cord Independence Measure (SCIM), presence of a caregiver, and length of hospital stay, were analyzed. Univariate and multivariate logistic regression analyses were performed to identify factors associated with falls during the rehabilitation process.
Results:
A total of 98 patients were included in the study (49 fallers and 49 non-fallers). The majority of falls occurred during transfers or bathroom use, most frequently during daytime hours. The presence of a caregiver was not significantly associated with the occurrence of falls (p > 0.05). Patients classified as AIS C demonstrated the highest proportion of falls (68.2%) among all groups. The WISCI score showed a borderline significant association with falls in the univariate analysis (p = 0.050); however, this association was not statistically significant in the multivariate logistic regression model.
Conclusion:
Falls among inpatients with SCI undergoing rehabilitation most frequently occurred during daytime activities, particularly during transfers and bathroom use. Functional mobility and neurological classification, especially AIS C, appeared to play a more critical role in fall risk than the presence of a caregiver. Preventive strategies should emphasize individualized rehabilitation approaches, environmental modifications, and targeted fall prevention programs for high-risk subgroups.
Sponsorship:
None.
