Cumulative Risk And Associated Factors For Fall-Related Fractures In Stroke Survivors After Discharge From Rehabilitation Wards: A Retrospective Study With A 6-Year Follow-Up
Keywords:accidental fall, bone fracture, cerebrovascular disorder, rehabilitation, risk factor
Objective: To investigate the long-term cumulative risk and factors associated with fall-related fractures in stroke survivors discharged from convalescent rehabilitation wards.
Design: Retrospective cohort study.
Participants: A total of 786 stroke survivors discharged from a rehabilitation hospital.
Methods: Data regarding fall-related fractures posthospital discharge were collected using self-reported questionnaires. The Kaplan–Meier method was used to calculate the cumulative incidence of fall-related fractures, and risk factors were analysed using Cox proportional hazard regression analysis.
Results: Of 1,861 consecutive stroke survivors who had been discharged from hospital, 786 (42.2%) provided information concerning fall-related fractures. Duration from time of discharge to time of collection of questionnaires ranged from 1 to 6 years (mean 38.0 months). The cumulative incidence of fall-related fractures at 1-, 2-, 3-, 4-, and 5-years post-discharge was 4.2%, 7.9%, 10.8%, 12.5% and 13.7%, respectively. Cox proportional hazard regression analysis indicated that female sex (hazard ratio (HR) 1.69) and moderate lower limb paresis (HR 3.08) were significant risk factors.
Conclusion: The cumulative risk of fall-related fractures in stroke survivors post-discharge from a rehabilitation hospital was notably high. Intensive preventive intervention should be considered for female stroke survivors with moderate lower limb paresis.
This study aimed to investigate the risk of fall-related fractures and associated factors in stroke survivors who had been discharged from rehabilitation wards. A questionnaire was sent by post to 1,861 post-discharge stroke survivors to investigate their experiences of fall-related fractures, to which 786 stroke survivors responded. The incidence of fall-related fractures at 1, 2, 3, 4, and 5 years post-discharge was 4.2%, 7.9%, 10.8%, 12.5% and 13.7%, respectively. The presence of moderate lower limb paresis and female sex were associated with 3.08- and 1.69-times higher risk of developing a fall-related fracture, respectively. Intensive preventive intervention should be considered for female stroke survivors with moderate lower limb paresis following discharge from rehabilitation wards.
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Copyright (c) 2022 Masashi Kumagai, Yohei Otaka, Taiki Yoshida, Shin Kitamura, Kazuki Ushizawa, Naoki Mori, Daisuke Matsuura, Kaoru Honaga, Kunitsugu Kondo, Eiji Shimizu
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.