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1. Prevalence, predictors, and outcomes of poststroke falls in acute hospital setting..................................... 1
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Prevalence, predictors, and outcomes of poststroke falls in acute hospital setting
Author: Schmid, Arlene A; Wells, Carolyn K; Concato, John; Dallas, Mary I; Lo, Albert C; Nadeau, Steven E;
Williams, Linda S; Peixoto, Aldo J; Gorman, Mark; Boice, John L; Struve, Frederick; McClain, Vincent; Bravata,
Dawn M

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Abstract: Falls are a serious medical complication following stroke. The objectives of this study were to (1)
confirm the prevalence of falls among patients with stroke during acute hospitalization, (2) identify factors
associated with falls during the acute stay, and (3) examine whether in-hospital falls were associated with loss
of function after stroke (new dependence at discharge). We completed a secondary analysis of data from a
retrospective cohort study of patients with ischemic stroke who were hospitalized at one of four hospitals. We
used logistic regression to identify factors associated with inpatient falls and examine the association between
falls and loss of function. Among 1,269 patients with stroke, 65 (5%) fell during the acute hospitalization period.
We found two characteristics independently associated with falls: greater stroke severity (National Institutes of
Health Stroke Scale [NIHSS] 8, adjusted odds ratio [OR] = 3.63, 95% confidence interval [CI]: 1.46-9.00) and
history of anxiety (adjusted OR = 4.90, 95% CI: 1.70-13.90). Falls were independently associated with a loss of
function (adjusted OR = 9.85, 95% CI: 1.22-79.75) even after adjusting for age, stroke severity, gait
abnormalities, and past stroke. Stroke severity (NIHSS >8) may be clinically useful during the acute inpatient
setting in identifying those at greatest risk of falling. Given the association between falls and poor patient
outcomes, rehabilitation interventions should be implemented to prevent falls poststroke. [PUBLICATION
ABSTRACT]
Subject: Hospitals; Older people; Family medical history; Hospitalization; Health services; Nursing care; Clinical
outcomes; Stroke; Falls;
MeSH: Activities of Daily Living, Acute Disease, Aged, Aged, 80 & over, Confidence Intervals, Female,
Hospitals, Veterans, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Prevalence, Retrospective
Studies, Risk Factors, Severity of Illness Index, Stroke -- epidemiology, Stroke -- physiopathology, Stroke --
rehabilitation, Treatment Outcome, Virginia -- epidemiology, Accidental Falls -- statistics & numerical data
(major), Hospitalization (major), Inpatients -- statistics & numerical data (major)
Publication title: Journal of Rehabilitation Research and Development
Volume: 47
Issue: 6
Pages: 553-62
Number of pages: 10
Publication year: 2010
Publication date: 2010
Year: 2010
Publisher: Superintendent of Documents
Place of publication: Washington
Country of publication: United States
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Publication subject: Medical Sciences--Surgery, Medical Sciences--Orthopedics And Traumatology,
Engineering
ISSN: 07487711
CODEN: JRRDDB
Source type: Scholarly Journals
Language of publication: English
Document type: Journal Article
Document feature: Tables References
Accession number: 20848368
ProQuest document ID: 752919472
Document URL: http://search.proquest.com/docview/752919472?accountid=50673
Copyright: Copyright Superintendent of Documents 2010
Last updated: 2014-04-01
Database: ProQuest Medical Library,ProQuest Nursing & Allied Health Source
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