Agreement and predictive performance of fall risk assessment methods and factors associated with falls in hospitalized older adults: A longitudinal study

• Published in: Geriatric nursing (New York) Vol. 49; pp. 109 - 114
• Main Authors: Silva, Sabrina de Oliveira, Barbosa, Jessica Bandeira, Lemos, Thiago, Oliveira, Laura Alice Santos, Ferreira, Arthur de Sá
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2023
• Subjects: Accidental falls; Aged; Diagnostic screening programs; Female; Health services for the aged; Hospitalization; Humans; Longitudinal Studies; Male; Prospective Studies; Rehabilitation; Risk Assessment - methods; Risk Factors; Hospitalization; Rehabilitation; Diagnostic screening programs; Accidental falls; Health services for the aged
• ISSN: 0197-4572; 1528-3984
• DOI: 10.1016/j.gerinurse.2022.11.016

•Fall risk assessment is valid/reliable for fall prediction in hospitalized older adults.•Predictive power for risk of falling varies depending on the applied questionnaires.•St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients has high performance.•Fall risk assessment methods and factors associated with falls only slightly agree.
Falls in hospitalized older adults are of concern and, despite the availability of fall risk assessment methods and knowledge about factors associated with falls, their validity and agreement remain poorly investigated. In a prospective study, we enrolled 102 hospitalized older adults (median [P25-P75]) 67 (64-73) years, 52 [51%] men, length of stay 20 [8-41] days). Fall risk was assessed at hospital admission using the Functional Independence Measure; Morse Fall Scale; St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients; Johns Hopkins Fall Risk Assessment Tool; and polypharmacy. The St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients method showed the highest predictive performance (accuracy 92%) for the identification of fallers during hospitalization. A slightly better-then-chance agreement was estimated between all methods (Light's κ = 0.120). Fall risk assessment methods and factors associated with falls should not be used interchangeably as their overall and pairwise agreement are fair at best.