The journal of nutrition, health & aging

, Volume 17, Issue 3, pp 264–269 | Cite as

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

  • L. Neumann
  • V. S. Hoffmann
  • S. Golgert
  • J. Hasford
  • Wolfgang von Renteln-Kruse
Article

Abstract

Objectives

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.

Design

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.

Setting

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

Participants

4,735 hospitalised patients ≥65 years.

Measurements

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

Results

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.

Conclusions

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 patients in-hospital falls risk screening functionality 

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Copyright information

© Serdi and Springer-Verlag France 2012

Authors and Affiliations

  • L. Neumann
    • 1
  • V. S. Hoffmann
    • 2
  • S. Golgert
    • 1
  • J. Hasford
    • 2
  • Wolfgang von Renteln-Kruse
    • 1
    • 3
  1. 1.Albertinen-Haus Geriatrics CentreUniversity of HamburgHamburgGermany
  2. 2.Institute of Medical Information Sciences, Biometry and Epidemiology (IBE)Ludwig-Maximilians-University MunichMunichGermany
  3. 3.Scientific Department at the University of HamburgHamburgGermany

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