Fall Risk Assessment Measures: An Analytic Review

Perell, Karen L.; Nelson, Audrey; Goldman, Ronald L.; Luther, Stephen L.; Prieto-Lewis, Nicole; Rubenstein, Laurence Z.

doi:10.1093/gerona/56.12.m761

Cited by 448 publications

(331 citation statements)

References 40 publications

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“…It is necessary to consider external and internal factors inclusively to develop fall prevention strategies for inpatients undergoing rehabilitation [18]. On the other hand, unnecessary restriction of activity to prevent falls goes against the purpose of rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

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Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan

Nakagawa

Sannomiya²,

Kinoshita

et al. 2008

Environ Health Prev Med

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Objective We conducted a study to develop an assessment sheet for fall prediction in stroke inpatients that is handy and reliable to help ward staff to devise a fall prevention strategy for each inpatient immediately upon admission. Methods The study consisted of three steps: (1) developing a data sampling form to record variables related to risk of falls in stroke inpatients and conducting a follow-up survey for stroke inpatients from their admission to discharge by using the form; (2) carrying out analyses of characteristics of the present subjects and selecting variables showing a high hazard ratio (HR) for falls using the Cox regression analysis; (3) developing an assessment sheet for fall prediction involving variables giving the integral coefficient for each variable in accordance with the HR determined in the second step. Results and discussion (1) Subjects of the present survey were 704 inpatients from 17 hospitals including 270 fallers.(2) We selected seven variables as predictors of the first fall: central paralysis, history of previous falls, use of psychotropic medicines, visual impairment, urinary incontinence, mode of locomotion and cognitive impairment. (3) We made 960 trial models in combination with possible coefficients for each variable, and among them we finally selected the most suitable model giving coefficient number 1 to each variable except mode of locomotion, which was given 1 or 2. The area under the ROC curve of the selected model was 0.73, and sensitivity and specificity were 0.70 and 0.69, respectively (4/5 at the cut-off point). Scores calculated from the assessment sheets of the present subjects by adding coefficients of each variable showed normal distribution and a significantly higher mean score in fallers (4.94 ± 1.29) than in non-fallers (3.65 ± 1.58) (P = 0.001). The value of the Barthel Index as the index of ADL of each subject was indicated to be in proportion to the assessment score of each subject. Conclusion We developed an assessment sheet for fall prediction in stroke inpatients that was shown to be available and valid to screen inpatients with risk of falls immediately upon admission.

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Section: Introductionmentioning

confidence: 99%

“…In convalescent rehabilitation wards the staff of various occupational categories cooperates to support rehabilitation of stroke inpatients, and all of them commonly recognize the risk of falls among inpatients [18,19]. It is also recognized that falls frequently occur within the first week after starting rehabilitation [20].…”

Section: Introductionmentioning

confidence: 99%

Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan

Nakagawa

Sannomiya²,

Kinoshita

et al. 2008

Environ Health Prev Med

View full text Add to dashboard Cite

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“…The Hendrich II Fall Risk Model score is one of many fall risk assessment tools designed to identify patients at risk for falls. 14,15 intErvEntion Our intervention consisted of adding a physician fall risk assessment for all patients at admission to the neurology unit. Physicians were instructed to make this judgment on the basis of their usual admission history taking and physical examination and were blinded to the nursing fall risk assessment.…”

Section: Existing Fall Risk Assessment Processmentioning

confidence: 99%

Effect of a Multidisciplinary Fall Risk Assessment on Falls Among Neurology Inpatients

Hunderfund

Sweeney

Mandrekar

et al. 2011

Mayo Clinic Proceedings

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“…18 ADL limitations are associated with a decreased likelihood of older adults leaving home and going into town, 25 while individuals with, compared to those without, impaired ADLs have twice the risk of a fall. 26 Balance and gait limitations, which may increase with less activity, are also fall risk predictors. 27 Also, the size and geography of a city has been associated with older adults' fear of falling.…”

Section: Introductionmentioning

confidence: 99%

Examining Contextual Influences on Fall-Related Injuries Among Older Adults for Population Health Management

Hoffman

Rodríguez

2015

Population Health Management

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The objectives were to assess the associations between fall-related injuries (FRIs) treated in the emergency department (ED) among older adults in California and contextual county-level physical, social, and economic characteristics, and to assess how county-level economic conditions are associated with FRIs when controlling for other county-level factors. Data from 2008 California ED discharge, Medicare Impact File, and County Health Rankings were used. Random effects logistic regression models estimated contextual associations between county-level factors representing economic conditions, the built environment, community safety, access to care, and obesity with patient-level FRI treatment among 1,712,409 older adults, controlling for patient-level and hospital-level characteristics. Patient-level predictors of FRI treatment were consistent with previous studies not accounting for contextual associations. Larger and rural hospitals had higher odds of FRI treatment, while teaching and safety net hospitals had lower odds. Better county economic conditions were associated with greater odds (ß = 0.73, P = 0.001) and higher county-level obesity were associated with lower odds (ß = -0.37, P = 0.004), but safer built environments (ß = -0.31, P = 0.38) were not associated with FRI treatment. The magnitude of association between county-level economic conditions and FRI treatment attenuated with the inclusion of countylevel obesity rates. FRI treatment was most strongly and consistently related to more favorable county economic conditions, suggesting differences in treatment or preferences for treatment for FRIs among older individuals in communities of varying resource levels. Using population health data on FRIs, policy makers may be able to remove barriers unique to local contexts when implementing falls prevention educational programs and built environment modifications. (Population Health Management 2015;18:437-448)

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Fall Risk Assessment Measures: An Analytic Review

Cited by 448 publications

References 40 publications

Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan

Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan

Effect of a Multidisciplinary Fall Risk Assessment on Falls Among Neurology Inpatients

Examining Contextual Influences on Fall-Related Injuries Among Older Adults for Population Health Management

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