Fracture risk and bone health following a stroke are inadequately considered by physicians: A UK survey of practice

Gaskell, Natalie; Choulerton, James; Shaw, Louise; Gregson, Celia L

doi:10.1016/j.eurger.2016.09.003

Cited by 2 publications

(2 citation statements)

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“…The UK National Clinical Guideline for Stroke 22 advises that all stroke survivors should have fragility fracture assessments and that calcium, vitamin D supplements and bisphosphonates should be prescribed if appropriate. A recent survey of 73 consultant stroke physicians conducted in the UK however 31 found that 58% of respondents rarely or never assessed bone health in stroke patients admitted to hospital, despite the vast majority of respondents regularly considering falls-risk. In the FREESE cohort at discharge, only 10% of recurrent fallers and none of those who experienced a fracture had recorded bone health medication prescriptions at discharge.…”

Section: Discussionmentioning

confidence: 99%

Falls-Related EvEnts in the first year after StrokE in Ireland: Results of the multi-centre prospective FREESE cohort study

Walsh

Galvin

Williams

et al. 2018

European Stroke Journal

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Introduction: Falls are common post-stroke adverse events. This study aimed to describe the first-year falls incidence, circumstances and consequences among persons discharged home after stroke in Ireland, and to examine the association between potential risk factors and recurrent falls. Patients and methods: Patients with acute stroke and planned home-discharge were recruited consecutively from five hospitals. Variables recorded pre-discharge included: age, stroke severity, co-morbidities, fall history, prescribed medications, hemi-neglect, cognition and functional independence (Barthel index). Falls were recorded with monthly diaries, and 6 and 12-month interviews. The association of pre-discharge factors with recurrent falls (>1 fall) was examined using univariable logistic regression. Results: A total of 128 participants (mean age ¼ 68.6, SD ¼ 13.3) were recruited; 110 completed the 12-month followup. The first-year falls incidence was 44.5% (95% CI ¼ 35.1-53.6) with 25.6% falling repeatedly (95% CI ¼ 18.5-34.4). Fallers experienced 1-18 falls (median ¼ 2) and five reported fractures; 47% of fallers experienced at least one fall outdoors. Only 10% of recurrent fallers had bone health medication prescribed at discharge. Lower Barthel index scores (<75/100, RR ¼ 4.38, 1.64-11.72) and psychotropic medication prescription (RR ¼ 2.10, 1.13-3.91) were associated with recurrent falls. Discussion: This study presents prospectively collected information about falls circumstances. It was not powered for multivariable analysis of risk factors. Conclusion: One-quarter of stroke survivors discharged to the community fall repeatedly and mostly indoors in the first year. Specific attention may be required for individuals with poor functional independence or those on psychotropic medication. Future falls-management research in this population should explore falls in younger individuals, outdoor as well as indoor falls and post-stroke bone health status.

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Section: Discussionmentioning

confidence: 99%

Falls-Related EvEnts in the first year after StrokE in Ireland: Results of the multi-centre prospective FREESE cohort study

Walsh

Galvin

Williams

et al. 2018

European Stroke Journal

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“…WHO estimates that more than 646,000 fatal falls occur annually in the general population, making falls the second leading cause of unintentional death after traffic accidents (1). More than 80% of deaths occur in low-and middle-income countries (7,8). Fall injuries of hospitalized patients have been reported in 5% of patients, with resulting fractures and severe injuries.…”

Section: Introductionmentioning

confidence: 99%

The risk of falls in patients with cerebrovascular disease

Nenadović,

Đurović,

Stanković

et al. 2023

Acta fac medic Naissensis

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Introduction/Aim. Patient falls in hospital conditions are among the most common serious adverse events following a cerebrovascular insult at all stages of the disease. The aim of this study was to investigate the risk of falls in patients with cerebrovascular disease. Methods. A clinical case-control observational study was conducted in this investigation. The sample consisted of patients who suffered from cerebrovascular diseases and were admitted to the Special Hospital for Cerebrovascular Diseases "Sveti Sava" in Belgrade, in the period from February 3, 2018, to June 28, 2019. The Morse questionnaire was used to assess a fall risk. All statistical calculations were performed using the standard commercial software package SPSS, version 21.0. Results. Most of the subjects with a cerebrovascular insult (505 (90.0%)) had a high risk of falls, i.e. they had the Morse score values ≥ 45. The mean Morse score of the subjects in the study was 67.07 ± 21.08. The risk of falling, according to the Morse score, is the highest among subjects diagnosed with bleeding (95.7%: 96.7%) and left-sided neurological deficit (91.7%:90.8%) in both examined groups. Conclusion. It is of great importance to organizing training programs for patients, healthcare providers, and medical staff to prevent falls in hospital conditions.

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Fracture risk and bone health following a stroke are inadequately considered by physicians: A UK survey of practice

Cited by 2 publications

References 13 publications

Falls-Related EvEnts in the first year after StrokE in Ireland: Results of the multi-centre prospective FREESE cohort study

Falls-Related EvEnts in the first year after StrokE in Ireland: Results of the multi-centre prospective FREESE cohort study

The risk of falls in patients with cerebrovascular disease

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