Skip Navigation

Age and Ageing 2008 37(3):277-281; doi:10.1093/ageing/afn062
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Supplementary Data
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Vassallo, M.
Right arrow Articles by Allen, S. C.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Vassallo, M.
Right arrow Articles by Allen, S. C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Copyright © The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society.

Fall risk-assessment tools compared with clinical judgment: an evaluation in a rehabilitation ward

Michael Vassallo, Lynn Poynter, Jagdish C. Sharma, Joseph Kwan and Stephen C. Allen

Royal Bournemouth Hospital, Medicine Castle Lane East Bournemouth, Dorset BH7 7DW, UK

Address correspondence to: Michael Vassallo. Tel: +44 (0)01202 704590; Fax: +44 (0)01202 704542. Email: michael.vassallo{at}rbch.nhs.uk; michaelvassallo{at}doctors.org.uk

Objectives: to compare the use of two falls risk-identification tools (Downton and STRATIFY) with clinical judgment (based upon the observation of wandering behaviour) in predicting falls of medically stable patients in a rehabilitation ward for older people.

Methods: in a prospective observational study, with blinded end-point evaluation, 200 patients admitted to a geriatric rehabilitation hospital had a STRATIFY and Downton Fall Risk assessment and were observed for wandering behaviour.

Results: wandering had a predictive accuracy of 78%. A total of 157/200 were identified correctly compared to 100/200 using the Downton score (P < 0.0001 95%, CI 0.18–0.42), or 93/200 using STRATIFY (P < 0.0001; 95% CI 0.15–0.37). The Downton and STRATIFY tools demonstrated predictive accuracies of 50% and 46.5%, respectively, with no statistical significance between the two (P = 0.55; 95% CI 0.77–1.71). Sensitivity for predicting falls using wandering was 43.1% (22/51). This was significantly worse than Downton 92.2% (47/51: P < 0.001) and STRATIFY 82.3% (42/51: P < 0.001).

Conclusions: this study showed that clinical observation had a higher accuracy than two used falls risk-assessment tools. However it was significantly less sensitive implying that fewer patients who fell were correctly identified as being at risk.

Keywords: falls, hospital, risk-assessment tools, clinical judgment, wandering, elderly

Received 4 September 2007; accepted in revised form 9 January 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Age AgeingHome page
D. Oliver
Falls risk-prediction tools for hospital inpatients. Time to put them to bed?
Age Ageing, May 1, 2008; 37(3): 248 - 250.
[Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.