Background: Falls can result in injury, activity limitation, decreased independence and death. There have been no studies investigating falls post intracerebral hemorrhage (ICH).
Purpose: To determine rate and factors associated with falls post ICH.
Methods: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study is a prospective, multi-center, case-control study of ICH. For this analysis, the primary outcome was fall reported at 3 month follow-up. Variables collected at baseline included age, sex, race, ICH score (volume, IVH, age, Glasgow Coma Scale) and fall during inpatient hospitalization. Variables collected at 3-month follow-up included modified Rankin (mRS), incontinence (Barthel) and anxiety/depression (EuroQol). Variables p<.10 were entered into a logistic regression with the final model consisting of variables p<.05, adjusting for ICH score.
Results: As of 12/31/2013, 2064 patients presented to an emergency department. After excluding deaths, premorbid mRS 4-5 and missing data, 1098 remained. At 3-month follow up, 200 (18.2%) reported a post-discharge fall including: 99 (50%) who fell more than once, 9 (4.5%) broken bones, 14 (7.0%) hospitalizations and 4 (2.0%) surgeries due to falls. The highest 3-month fall rates was observed among persons with mRS 3 (55/206, 26.7%), mRS 4 (79/253, 31.2%), extreme anxiety (19/64, 29.7%) and among those who had fallen during inpatient hospitalization (44/168, 26.2%). Variables associated with a 3 month fall were: race, mRS, ICH Score, a fall during inpatient hospitalization, incontinence and anxiety/depression (Table 1). Adjusting for ICH score, the final model included race, mRS and anxiety/depression.
Conclusions: Assessing factors associated with falls can help target high risk patients. After 12 month follow up is complete, the next step will be to analyze factors associated with a fall during the first year post ICH and examine causation.
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