Literature DB >> 15935030

A comparative study of the use of four fall risk assessment tools on acute medical wards.

Michael Vassallo1, Rachel Stockdale, Jagdish C Sharma, Roger Briggs, Stephen Allen.   

Abstract

OBJECTIVES: To compare the effectiveness of four falls risk assessment tools (STRATIFY, Downton, Tullamore, and Tinetti) by using them simultaneously in the same environment.
DESIGN: Prospective, open, observational study.
SETTING: Two acute medical wards admitting predominantly older patients. PARTICIPANTS: One hundred thirty-five patients, 86 female, mean age+/-standard deviation 83.8+/-8.01 (range 56-100). MEASUREMENTS: A single clinician prospectively completed the four falls risk assessment tools. The extent of completion and time to complete each tool was recorded. Patients were followed until discharge, noting the occurrence of falls. The sensitivity, specificity, negative predictive accuracy, positive predictive accuracy, and total predictive accuracy were calculated.
RESULTS: The number of patients that the STRATIFY correctly identified (n=90) was significantly higher than the Downton (n=46; P<.001), Tullamore (n=66; P=.005), or Tinetti (n=52; P<.001) tools, but the STRATIFY had the poorest sensitivity (68.2%). The STRATIFY was also the only tool that could be fully completed in all patients (n=135), compared with the Downton (n=130; P=.06), Tullamore (n=130; P=.06), and Tinetti (n=17; P<.001). The time required to complete the STRATIFY tool (average 3.85 minutes) was significantly less than for the Downton (6.34 minutes; P<.001), Tinetti (7.4 minutes; P<.001), and Tullamore (6.25 minutes; P<.001). The Kaplan-Meier test showed that the STRATIFY (log rank P=.001) and Tullamore tools (log rank P<.001) were effective at predicting falls over the first week of admission. The Downton (log rank P=.46) and Tinetti tools (log rank P=.41) did not demonstrate this characteristic.
CONCLUSION: Significant differences were identified in the performance and complexity between the four risk assessment tools studied. The STRATIFY tool was the shortest and easiest to complete and had the highest predictive value but the lowest sensitivity.

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Mesh:

Year:  2005        PMID: 15935030     DOI: 10.1111/j.1532-5415.2005.53316.x

Source DB:  PubMed          Journal:  J Am Geriatr Soc        ISSN: 0002-8614            Impact factor:   5.562


  14 in total

Review 1.  The Tinetti test: Babylon in geriatric assessment.

Authors:  Sascha Köpke; Gabriele Meyer
Journal:  Z Gerontol Geriatr       Date:  2006-08       Impact factor: 1.281

2.  THE RELATIONSHIP OF MEMORY, REASONING, AND SPEED OF PROCESSING ON FALLING AMONG OLDER ADULTS.

Authors:  David E Vance; Lesley A Ross; Michael G Crowe; Virginia G Wadley; Jerri D Edwards; Karlene K Ball
Journal:  Phys Occup Ther Geriatr       Date:  2008

Review 3.  Predicting geriatric falls following an episode of emergency department care: a systematic review.

Authors:  Christopher R Carpenter; Michael S Avidan; Tanya Wildes; Susan Stark; Susan A Fowler; Alexander X Lo
Journal:  Acad Emerg Med       Date:  2014-10-07       Impact factor: 3.451

4.  Subclinical Peroneal Neuropathy: A Common, Unrecognized, and Preventable Finding Associated With a Recent History of Falling in Hospitalized Patients.

Authors:  Louis H Poppler; Andrew P Groves; Gina Sacks; Anchal Bansal; Kristen M Davidge; Jenifer A Sledge; Heidi Tymkew; Yan Yan; Jessica M Hasak; Patricia Potter; Susan E Mackinnon
Journal:  Ann Fam Med       Date:  2016-11       Impact factor: 5.166

5.  Malnutrition and risk of falling among elderly without home-help service--a cross sectional study.

Authors:  A Westergren; P Hagell; C Sjödahl Hammarlund
Journal:  J Nutr Health Aging       Date:  2014-12       Impact factor: 4.075

Review 6.  A systematic review and meta-analysis of studies using the STRATIFY tool for prediction of falls in hospital patients: how well does it work?

Authors:  David Oliver; Alexandra Papaioannou; Lora Giangregorio; Lehana Thabane; Katerina Reizgys; Gary Foster
Journal:  Age Ageing       Date:  2008-10-01       Impact factor: 10.668

7.  World Health Organization fracture risk assessment tool in the assessment of fractures after falls in hospital.

Authors:  Shin-ichi Toyabe
Journal:  BMC Health Serv Res       Date:  2010-04-27       Impact factor: 2.655

Review 8.  Diagnostic accuracy of the STRATIFY clinical prediction rule for falls: a systematic review and meta-analysis.

Authors:  Jennifer Billington; Tom Fahey; Rose Galvin
Journal:  BMC Fam Pract       Date:  2012-08-07       Impact factor: 2.497

Review 9.  Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis.

Authors:  Marta Aranda-Gallardo; Jose M Morales-Asencio; Jose C Canca-Sanchez; Silvia Barrero-Sojo; Claudia Perez-Jimenez; Angeles Morales-Fernandez; Margarita Enriquez de Luna-Rodriguez; Ana B Moya-Suarez; Ana M Mora-Banderas
Journal:  BMC Health Serv Res       Date:  2013-04-02       Impact factor: 2.655

10.  Process factors explaining the ineffectiveness of a multidisciplinary fall prevention programme: a process evaluation.

Authors:  Michel H C Bleijlevens; Marike R C Hendriks; Jolanda C M van Haastregt; Erik van Rossum; Gertrudis I J M Kempen; Joseph P M Diederiks; Harry F J M Crebolder; Jacques Th M van Eijk
Journal:  BMC Public Health       Date:  2008-09-24       Impact factor: 3.295

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