Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT)

Objective: This study aimed to investigate incidence of falls and different baseline variables and their association with falling during hospitalization in a stroke unit among patients with acute stroke. Design: Prospective observational study. Setting: A stroke unit at a university hospital. Subjects: A consecutive sample of stroke patients, out of which 504 were included, while 101 declined participation. Methods: The patients were assessed a mean of 1.7days after admission and 3.8days after stroke onset. Main measures: The primary end-point was any fall, from admission to the stroke unit to discharge. Factors associated with falling were analysed using univariable and multivariable Cox hazard regression analyses. Independent variables were related to function, activity and participation, as well as personal and environmental factors. Results: In total, 65 patients (13%) fell at least once. Factors statistically significantly associated with falling in the multivariable analysis were male sex (hazard ratio (HR): 1.88, 95% confidence interval (CI): 1.13-3.14, P=0.015), use of a walking aid (HR: 2.11, 95% CI: 1.24-3.60, P=0.006) and postural control as assessed with the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS). No association was found with age, cognition or stroke severity, the HR for low SwePASS scores (24) was 9.33 (95% CI: 2.19-39.78, P=0.003) and for medium SwePASS scores (25-30) was 6.34 (95% CI: 1.46-27.51, P=0.014), compared with high SwePASS scores (31). Conclusion: Postural control, male sex and use of a walking aid are associated with falling during hospitalization after acute stroke.