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

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 post-hospital 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.