Factors affecting fall among individuals with traumatic brain injury during inpatient rehabilitation at a tertiary care facility in Saudi Arabia

Abstract EN

Objectives:To determine the incidence and association of risk factors of falls among patients with traumatic brain injury (TBI) undergoing inpatient rehabilitation in Saudi population, and to analyze the association of clinical attributes among fallers and non–fallers.

Methods: One hundred and seventy adults (>18 years age) with a diagnosis of TBIadmitted to tertiary care rehabilitation hospital from May 2015 and July 2017 were included in the study.

Data was collected regarding demography, fall characteristics, and information related to brain injury were included.

Chart review also included ,functional independence measure (FIM) scores and length of hospital stay.

Data were summarized as averages (means and medians) or percentage frequencies, and quantitative and categorical differences were identified using Student’s t-tests and Chi-square and Fisher exact tests, respectively.

Results: Out of 170 patients, nearly 12% of individuals with TBI had fall during inpatient rehabilitation, of whom 18 (90%) fell only once.

Most falls occurred from beds (30%) and during the daytime (75%).Mean gains in FIM values were 28.6 ± 20 and 41.5 ± 19.7 among non-fallers and fallers respectively, and differed significantly between patient groups (p < 0.001).

Mean durations of hospitalization were 75.9 ± 64.8 and 80.2 ± 42.7 days in non-fallers and fallers, this difference was not statistically significant (p=0.775).Fall risk was associated with FIM gain (p<0.001), use of anticonvulsants (p=0.045) and antihypertensive drugs (p=0.047).

Conclusion:Individuals with TBI who sustained falls tend to stay longer during inpatient rehabilitation.

Fall prevention strategies need to be emphasized for individuals with TBI admitted to inpatient rehabilitation with special measures to prevent falls during daytime.

Due to their significant association with falls, identification of patients with seizures, and those who are taking anticonvulsants and antihypertensive drugs are important considerations.