Objective-To compare length of stay, functional status, and discharge destination between individuals who fell during in-patient stroke rehabilitation and those who did not fall.
Design-Retrospective cohort study.
Setting-Rehabilitation hospital.Participants-Individuals who fell during in-patient stroke rehabilitation (n=106; fallers group; mean age=67.8 years, SD=12.9; mean time post-stroke=26.4 days, SD=28.3) were matched to individuals who did not fall (n=106; non-fallers group; mean age=67.3 years, SD=13.6; mean time post-stroke=21.9 days, SD=28.8) on age and functional status (N=212).
Interventions-Not applicable.Main outcome measures-Total length of stay, Functional Independence Measure (FIM) assessed at discharge, and discharge destination.Results-The mean length of stay for fallers was 11 days longer than non-fallers (p=0.0017). Non-fallers and fallers did not differ on discharge total FIM scores (p=0.19), and both groups were discharged home after in-patient rehabilitation (non-fallers: 77%; fallers: 74%; p=0.52).Conclusions-This study suggests that falls experienced during in-patient stroke rehabilitation may have contributed to a longer length of stay; however, falls did not impact discharge functional status or discharge destination. In-patient rehabilitation is a health care setting where patients are focused on improving function and maximizing their abilities. It is typically delivered during the sub-acute stage of stroke recovery (i.e. less than three months post-stroke) when patients are likely to receive the most benefit from intensive therapy. 17,18 Unfortunately, there is limited available evidence for the effectiveness of falls prevention interventions after stroke across acute care, rehabilitation, community, and institutional care settings. 19,20 Thus, the incidence of falls will remain of concern, as it may not be possible to prevent every fall.
KeywordsLittle evidence exists on the impact of falls on rehabilitation outcomes; therefore, it is important to understand the effect that falls have on the course of patient recovery and delivery of care during the critical sub-acute phase of stroke. The primary objective of this study was to compare length of stay, functional status, and discharge destination between individuals who fell during in-patient stroke rehabilitation and those who did not fall. It was hypothesized that patients who fell would have poorer recovery compared to those who did not fall. This would be demonstrated by a longer length of stay, worse functional outcomes at discharge, and less likely to be discharged home following the rehabilitation stay among individuals who fell.
METHODS
Study designA retrospective cohort study involving a chart review was conducted. The chart review involved consecutive admissions to the specialized stroke unit at the Toronto Rehabilitation Institute from October 1, 2009 to September 30, 2012. The Toronto Rehabilitation Institute Research Ethics Board approved this study, and a waiver of patient consent for the purpose of this review...