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Fall-related injuries in anticoagulated stroke patients during inpatient rehabilitation
J Stein1, B E Viramontes, D C Kerrigan
1Division of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
Objective:
To compare the frequency and severity of fall-related injuries in anticoagulated patients undergoing rehabilitation after stroke to nonanticoagulated stroke patients undergoing rehabilitation.
Design:
Retrospective chart review.
Setting:
Free-standing rehabilitation hospital.
Patients:
264 patients who sustained falls while undergoing intensive inpatient rehabilitation after stroke.
Measurements:
Injuries, categorized as minor (abrasions and bruises) or major (intracranial hemorrhage, fracture, major bleeding).
Main Results:
A total of 400 falls in 264 patients undergoing inpatient stroke rehabilitation were reviewed. One hundred thirty-one falls were sustained by 93 patients receiving anticoagulation, whereas 269 falls were sustained by 175 patients not receiving anticoagulation. In both the anticoagulation group and the control (nonanticoagulated) group, approximately one in five falls resulted in minor injuries (abrasions or bruises). Three fractures occurred, but no major bleeding events or intracranial hemorrhage occurred in either group.
Conclusions:
The risk for minor injury secondary to fall is comparable between the two groups, and the risk is low in this setting for hemorrhagic injuries in stroke patients falling while receiving anticoagulation.