High incidence of falls and fall-related injuries in wheelchair users with spinal cord injury: A prospective study of risk indicators

Abstract

Objective: To identify risk indicators for, and incidence of, recurrent falls and fall-related injuries in wheelchair users with traumatic spinal cord injury. Design: Prospective multi-centre study. Subjects: One hundred and forty-nine wheelchair users with spinal cord injury attending follow-up in Sweden and Norway. Methods: Inclusion criteria: wheelchair users ≥ 18 years old with traumatic spinal cord injury ≥ 1 year post-injury. Exclusion criteria: individuals with motor complete injuries above C5. Falls were prospectively reported by text message every second week for one year and were followed-up by telephone interviews. Outcomes were: fall incidence, risk indicators for recurrent >2) falls and fall-related injuries. Independent variables were: demographic data, quality of life, risk willingness, functional independence, and exercise habits. Results: Of the total sample (n=149), 96 (64%) participants fell, 45 (32%) fell recurrently, 50 (34%) were injured, and 7 (5%) severely injured. Multivariate logistic regression analysis showed that reporting recurrent falls the previous year increased the odds ratio (OR) of recurrent falls (OR 10.2, p<0.001). Higher quality of life reduced the OR of fall-related injuries (OR 0.86, p=0.037). Conclusion: Previous recurrent falls was a strong predictor of future falls. The incidence of falls, recurrent falls and fall-related injuries was high. Hence, prevention of falls and fall-related injuries is important.