Abstract W P320: Falls with Injury After Stroke are Associated With Incontinence and Depression

Background: Approximately 22% to 73% of persons with stroke fall yearly. Falls can result in injury, activity limitation, decreased independence and death. Several studies have investigated falls during and after inpatient rehabilitation. A community based cohort with longitudinal follow up is needed to provide prospective insight into the risk factors for falls in the general stroke population. Purpose: To determine rate and predictors of fall with injury 3 and 12 months post stroke Methods: During 2005, 460 ischemic stroke patients from the Greater Cincinnati/Northern Kentucky region were prospectively enrolled from all regional hospitals. Baseline data were collected in the acute hospital, and 3- and 12-month follow-up data were collected by subject or proxy interviews. Primary outcome was fall with injury categorized dichotomously (yes, no), analyzed separately at 3 and 12 months. Predictor variables collected at baseline included age, gender, race, and National Institutes of Health Stroke Scale (NIHSS). Predictor variables collected at 3 and 12 months included urinary incontinence (yes, no) and Center for Epidemiologic Studies Depression (CES-D) scale (score ranging from 0-30). Variables with p<.10 were entered into the model. Final model maintained all variables with p<.05, adjusting for NIHSS. Results: Of the 460 patients in the cohort, 27 had died by 3 months post, and another 62 had died by 12 months. Of the surviving patients, 37 of 346 (10.7%) who completed the 3-month follow-up and 33 of 247 (13.4%) who completed the 12-month follow-up reported a fall with injury. Table 1 shows demographics and results by outcome. Conclusions: At least 10% of patients with fairly mild stroke (average NIHSS 5) reported a fall with injury during the first year post stroke. Adjusting for NIHSS, urinary incontinence and depression were associated with a fall with injury.