Predictors of falls in persons with spinal cord injury—a prospective study using the Downton fall risk index and a single question of previous falls

Forslund, Emelie Butler; Jørgensen, Vivien; Roaldsen, Kirsti Skavberg; Hultling, Claes; Wahman, Kerstin; Franzén, Erika

doi:10.1038/s41393-018-0175-y

Cited by 11 publications

(3 citation statements)

References 23 publications

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“…Participants who did not experience a fall during the tracking period are represented as censored events. 36 Time to first fall has been used to compare fall data, including risk, among individuals with SCI 36 , 37 and has been used as an outcome measure to determine success of fall reduction interventions. 38 , 39…”

Section: Methodsmentioning

confidence: 99%

Comparing the causes, circumstances and consequences of falls across mobility statuses among individuals with spinal cord injury: A secondary analysis

Singh

Cheung

Chan

et al. 2021

The Journal of Spinal Cord Medicine

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Objective To compare the occurrence of falls and fall-related injuries, and the circumstances of falls among individuals with spinal cord injury (SCI) who ambulate full-time, use a wheelchair full-time and ambulate part-time. Design A secondary analysis. Setting Community. Participants Adults with SCI. Intervention None. Outcome measures The occurrence and circumstances of falls and fall-related injuries were tracked over six-months using a survey. Participants were grouped by mobility and fall status. A chi-square test compared the occurrence of falls and fall-related injuries, and the time and location of falls, and a negative binomial regression was used to predict the likelihood of falls by mobility status. Kaplan-Meier analysis was used to determine differences in the time to first fall based on mobility status. Group characteristics and causes of falls were described. Results Data from individuals who ambulated full-time ( n = 30), used a wheelchair full-time ( n = 27) and ambulated part-time ( n = 8) were analyzed. Mobility status was a significant predictor of falls (P < 0.01); individuals who used a wheelchair full-time had a third of the likelihood of falling than those who ambulated full-time (P < 0.01). Type of fall-related injuries differed by mobility status. Those who ambulated full-time fell more in the daytime (P < 0.01). Individuals who ambulated full-time and part-time commonly fell while walking due to poor balance, and their legs giving out, respectively. Those who used a wheelchair full-time typically fell while transferring when rushed. Conclusion Mobility status influences the likelihood and circumstances of falls. Mobility status should be considered when planning fall prevention education/training for individuals with SCI.

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Section: Methodsmentioning

confidence: 99%

Comparing the causes, circumstances and consequences of falls across mobility statuses among individuals with spinal cord injury: A secondary analysis

Singh

Cheung

Chan

et al. 2021

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

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“…Evidence-based clinical practice guidelines must be developed to reduce the incidence of falls from wheelchairs and to prevent life-altering injuries associated with falls. A study was conducted by Butler Foslund et al (2019) to determine predictors of falls of persons with a spinal cord injury. Downton fall risk index and a question regarding fall occurrence were utilized.…”

Section: Literature Reviewmentioning

confidence: 99%

Case Report

Sims¹

2022

Journal of Pediatric Surgical Nursing

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Falls from wheelchairs are common, particularly in persons with a spinal cord injury. Patients who experience falls frequently incur physical and psychological damages. The underlying causes of falls vary, although one of the most important themes is associated with poor balance. Factors that contribute to ineffective balance include poor trunk and abdominal muscle strength, inability to maintain static or dynamic trunk control, diminished sensation, improper equipment usage, muscle spasms, unsafe speed of mobilization, and lack of protective straps. The literature regarding fall prevention of pediatric patients with a spinal cord injury is very limited. Guidance is needed for this vulnerable population to prevent falls from wheelchairs. Instructions for wheelchair safety must be incorporated into patient and family caregiver education. Behavioral change theory provides a framework for this work. This article is intended to close the gap by discussing the incidence of falls, suggesting the provision of teaching self-management, and introducing suggestions for developing an interdisciplinary fall prevention program.

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“…The inability of conventional approaches to identifying patients at risk of falling, including fall risk screening questions and fall risk assessment tools, to successfully guide interventions to reduce fall injuries in acute care hospital settings may be due, at least in part, to poor fall prediction performance. Patient attributes that have been reported to influence fall risk include mental status, 14 toileting needs, 15 mobility impairment, 16 history of falls, 17 medications, 18 diabetes and poor blood glucose control, 19 and age, 20 among many others. 21 However, systematic reviews of conventional approaches to predict fall risk in hospitals report that their performance may not be considered clinically useful.…”

Section: Open Accessmentioning

confidence: 99%

Clinical prediction models for hospital falls: a scoping review protocol

2021

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IntroductionFalls remain one of the most prevalent adverse events in hospitals and are associated with substantial negative health impacts and costs. Approaches to assess patients’ fall risk have been implemented in hospitals internationally, ranging from brief screening questions to multifactorial risk assessments and complex prediction models, despite a lack of clear evidence of effect in reducing falls in acute hospital environments. The increasing digitisation of hospital systems provides new opportunities to understand and predict falls using routinely recorded data, with potential to integrate fall prediction models into real-time or near-real-time computerised decision support for clinical teams seeking to mitigate fall risk. However, the use of non-traditional approaches to fall risk prediction, including machine learning using integrated electronic medical records, has not yet been reviewed relative to more traditional fall prediction models. This scoping review will summarise methodologies used to develop existing hospital fall prediction models, including reporting quality assessment.Methods and analysisThis scoping review will follow the Arksey and O’Malley framework and its recent advances, and will be reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews recommendations. Four electronic databases (CINAHL via EBSCOhost, PubMed, IEEE Xplore and Embase) will be initially searched for studies up to 12 November 2020, and searches may be updated prior to final reporting. Additional studies will be identified by reference list review and citation analysis of included studies. No restriction will be placed on the date or language of identified studies. Screening of search results and extraction of data will be performed by two independent reviewers. Reporting quality will be assessed by the adherence to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis.Ethics and disseminationEthical approval is not required for this study. Findings will be disseminated through peer-reviewed publication and scientific conferences.

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Predictors of falls in persons with spinal cord injury—a prospective study using the Downton fall risk index and a single question of previous falls

Abstract: Falls in the previous year showed a better predictive accuracy than DFRI due to the low sensitivity of DFRI. As previous falls had low specificity, it still remains difficult to predict falls in those who have not fallen yet.

Cited by 11 publications

References 23 publications

Comparing the causes, circumstances and consequences of falls across mobility statuses among individuals with spinal cord injury: A secondary analysis

Comparing the causes, circumstances and consequences of falls across mobility statuses among individuals with spinal cord injury: A secondary analysis

Case Report

Clinical prediction models for hospital falls: a scoping review protocol

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