Stroke Patients with Nearly Independent Transfer Ability are at High Risk of Falling

Objectives: To examine the relationship between patients’ transfer ability and fall risk in stroke patients during hospitalization. Materials and methods: We retrospectively enrolled 237 stroke patients who were transferred to a convalescent rehabilitation ward from acute wards in the same hospital. Using incident reports, we investigated their fall rates and activity status at the falls according to their transfer abilities, which were assessed with Functional Independence Measure (FIM) transfer scores. The bi-weekly time trend of fall rates in all patients and in three subgroups based on FIM transfer scores of 1–3, 4–5, and 6–7, and activity status at the falls, were investigated. In addition, changes of patients’ transfer ability on admission, at the first fall, and at discharge were investigated among falling patients. Results: The fall rate was the greatest in patients with a FIM transfer score of 4 (14.3 times/1000 person-days). The majority of falls for patients with a FIM transfer score of 1 occurred at the activity status of “on the bed” and “sitting”, while three quarters of patients with a FIM score of 7 had falls during “standing” and “walking”. No longitudinal trend in fall rates was found overall; however, the fall rate trends differed depending on the FIM transfer score. The majority of the patients who fell required full assistance for transfers upon admission but required no assistance at discharge. Conclusions: Fall risk differed among patients with various transfer abilities; the greatest risk was in those who needed minimal assistance for transfers.