Association between stroke severity and fall risk among stroke patients.

BACKGROUND Falls are common after stroke. Simple, clinically practical tools are needed to easily identify patients with stroke who are at risk of falls. The objective of this study was to identify the factors associated with increased fall risk in a poststroke population. METHODS We assessed factors associated with fall risk among poststroke patients. Fall risk was determined through a history of falls, physical examination, observations of transfers, gait, balance, strength, range of motion, and use of assistive devices. Stroke severity was evaluated using the NIH Stroke Scale (NIHSS); mild or moderate-severe stroke was defined as a NIHSS score of <4 or > or = 4, respectively. RESULTS Among 52 poststroke patients, 26 (50%) were considered at risk of falls. Patients at risk of falls compared with those without fall risk were more likely to have greater stroke severity, decreased functional status, and to be more dependent in activities of daily living. Increased stroke severity was independently associated with higher fall risk (NIHSS > or = 4: OR = 5.73; 95% CI: 1.645-19.94). CONCLUSION Poststroke patients at risk of falls can be identified by an NIHSS score of > or = 4. Clinicians should screen patients for fall risk so that fall prevention strategies can be instituted.