Who are most at risk of falls post-stroke?

Men are more likely to encounter falls in the acute phase after stroke, a recent study has found. Other notable risk factors include haemorrhagic stroke, moderate stroke symptoms, impaired postural control, and smoking.

Drawing from local and national registries in Sweden, the researchers analysed an unselected sample of 5,065 stroke patients (median age 76 years, 47.3 percent women) seeking care at a dedicated stroke unit. Logistic regression analyses were conducted to identify independent determinants of falls during the patients’ stay in the stroke unit.

Of the included patients, 428 had experienced a fall in the stroke unit, yielding an incidence rate of 8.5 percent. Unadjusted analysis identified 17 factors potentially associated with falls, including: age; sex; comorbidities such as diabetes mellitus and atrial fibrillation; cognitive impairment; postural control; and previous falls, among others.

Meanwhile, multivariable adjustment revealed that sex was a significant and independent correlate of falls after stroke, with men suffering from more than twice the odds as women (odds ratio [OR], 2.25, 95 percent confidence interval [CI], 1.79–2.84; p<0.0001). Those who had haemorrhagic vs infarction strokes were likewise at higher risk of falls (OR, 1.39, 95 percent CI, 1.05–1.86).

Smoking was likewise identified as a significant risk factor (OR, 1.70, 95 percent CI, 1.29–2.25; p=0.0002), as were impaired postural control during walking (OR, 4.61, 95 percent CI, 3.29–6.46; p<0.0001) and while standing (OR, 1.60, 95 percent CI, 1.25–2.05; p=0.0002).

Other independent correlates included arm and hand problems, cognitive impairment, urinary infection, and the National Institutes of Health Stroke Scale score.