The journal of nutrition, health & aging

, Volume 17, Issue 3, pp 264–269

In-hospital fall-risk screening in 4,735 geriatric patients from the LUCAS project


  • L. Neumann
    • Albertinen-Haus Geriatrics CentreUniversity of Hamburg
  • V. S. Hoffmann
    • Institute of Medical Information Sciences, Biometry and Epidemiology (IBE)Ludwig-Maximilians-University Munich
  • S. Golgert
    • Albertinen-Haus Geriatrics CentreUniversity of Hamburg
  • J. Hasford
    • Institute of Medical Information Sciences, Biometry and Epidemiology (IBE)Ludwig-Maximilians-University Munich
    • Albertinen-Haus Geriatrics CentreUniversity of Hamburg
    • Scientific Department at the University of Hamburg

DOI: 10.1007/s12603-012-0390-8

Cite this article as:
Neumann, L., Hoffmann, V.S., Golgert, S. et al. J Nutr Health Aging (2013) 17: 264. doi:10.1007/s12603-012-0390-8



In-hospital falls in older patients are frequent, but the identification of patients at risk of falling is challenging. Aim of this study was to improve the identification of high-risk patients. Therefore, a simplified screening-tool was developed, validated, and compared to the STRATIFY predictive accuracy.


Retrospective analysis of 4,735 patients; evaluation of predictive accuracy of STRATIFY and its single risk factors, as well as age, gender and psychotropic medication; splitting the dataset into a learning and a validation sample for modelling fall-risk screening and independent, temporal validation.


Geriatric clinic at an academic teaching hospital in Hamburg, Germany.


4,735 hospitalised patients ≥65 years.


Sensitivity, specificity, positive and negative predictive value, Odds Ratios, Youden-Index and the rates of falls and fallers were calculated.


There were 10.7% fallers, and the fall rate was 7.9/1,000 hospital days. In the learning sample, mental alteration (OR 2.9), fall history (OR 2.1), and insecure mobility (Barthel-Index items ‘transfer’ + ‘walking’ score = 5, 10 or 15) (OR 2.3) had the most strongest association to falls. The LUCAS Fall-Risk Screening uses these risk factors, and patients with ≥2 risk factors contributed to the high-risk group (30.9%). In the validation sample, STRATIFY SENS was 56.8, SPEC 59.6, PPV 13.5 and NPV 92.6 vs. LUCAS Fall-Risk Screening was SENS 46.0, SPEC 71.1, PPV 14.9 and NPV 92.3.


Both the STRATIFY and the LUCAS Fall-Risk Screening showed comparable results in defining a high-risk group. Impaired mobility and cognitive status were closely associated to falls. The results do underscore the importance of functional status as essential fall-risk factor in older hospitalised patients.

Key words

Older patientsin-hospital fallsrisk screeningfunctionality
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© Serdi and Springer-Verlag France 2012