Fall risk after a stroke: Mean follow-up of 2 years

Introduction Falls is the third cause of post-stroke rehospitalizations. Clinical profiles and risk factors of fallers after stroke are still debated. Their better understanding is required for an active prevention. The main objective of our study was to determine the profile of post-stroke fallers. Material and methods We analysed data of 178 individuals of the DOBRAS cohort, who had been comprehensively assessed (deficits and activity limitations) in the rehabilitation ward 30 days after a first hemispheric stroke, then were followed especially regarding postural and gait recovery… Falls were monitored, from factual information during the stay in the rehabilitation department, then from interviews at regular clinical consultations, completed if required by phone calls at the final review (median 2 years; Q1–Q3 7–67 months post-stroke). Their main characteristics were: age 66 years old [Q1 = 55.7–Q3 = 72.0], 67% of males. The stroke touched the right hemisphere in 40% of cases, and was due to a cerebral infarct in 85%. Multivariable logistic regressions were performed on the basis of univariate analyses. Results Out of the 178 individuals, 25 (14%) fell once and 47 (26%) several times. Half of those who fell in the rehabilitation ward also fell after discharge. Univariate comparisons between fallers and non-fallers found several significant differences with medium effect sizes, so determining the clinical profile of future fallers as early as 1 month post-stroke. Fallers had a more extended stroke (P = 0.014), with greater weakness spasticity, hemineglect, and lateropulsion (all P  Discussion One month after a hemisphere stroke, it is possible to detect patients having a high risk of future fall. This should help for an active prevention.