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.
Masashi Kumagai, Yohei Otaka, Taiki Yoshida and 7 others
PMID 35652928WHAT IT FOUND
After discharge from convalescent stroke rehabilitation, 13.7% had a fall-related fracture within 5 years.
Female sex and moderate leg weakness at discharge were linked to higher fracture risk, especially in the first year.
Key findings
01Cumulative incidence of first fall-related fracture after discharge was 4.2% at 1 year, 7.9% at 2 years, 10.8% at 3 years, 12.5% at 4 years and 13.7% at 5 years.
02In the adjusted analysis, female sex and moderate lower-limb paresis at discharge were associated with higher fall-related fracture risk: female sex hazard ratio 1.69; lower-limb SIAS 9-11 points hazard ratio 3.08; lower-limb SIAS 6-8 points hazard ratio 3.05.
03Hip fractures were the most common first fall-related fracture (38.9%, n = 35), followed by proximal humerus (14.4%, n = 13) and wrist (10.0%, n = 9); hip and proximal humerus fractures were more often on the more-affected side, while wrist fractures were more often on the less-affected side.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 786 of 1,861 surveyed individuals had usable fall-fracture data, and 201 more were excluded from the adjusted analysis, including 25 who had experienced fractures. The response rate was low, and people who had fractures may have been more or less likely to reply, so incidence could be overestimated or underestimated. Fracture information came from participants or families, and cognitive function was not accurately assessed, so responses may be unreliable. The study was done at one facility, so results may not apply to other settings. The adjusted hazard ratios had wide confidence intervals, and the female sex association had a lower confidence limit of 1.00. The study was retrospective and did not test any fall-prevention intervention.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read the hazard ratios as proof that a fall-prevention programme reduces fractures. The study observed associations after discharge and did not test an intervention.