Development and evaluation of evidence based risk assessment tool (STRATIFY) to predict which elderly inpatients will fall : case-control and cohort studies.
To identify clinical characteristics of elderly inpatients that predict their chance of falling (phase 1) and to use these characteristics to derive a risk assessment tool and to evaluate its power in predicting falls (phases 2 and 3).
Phase 1 : a prospective case-control study.
Phases 2 and 3 : prospective evaluations of the derived risk assessment tool in predicting falls in two cohorts.
Elderly care units of St Thomas's Hospital (phase 1 and 2) and Kent and Canterbury Hospital (phase 3).
Elderly hospital inpatients (aged = 65 years) : 116 cases and 116 controls in phase 1,217 patients in phase 2, and 331 in phase 3. Main outcome measures : 21 separate clinical characteristics were assessed in phase 1, including the abbreviated mental test score, modified Barthel index, a transfer and mobility score obtained by combining the transfer and mobility sections of the Barthel index, and several nursing judgments.
In phase 1 five factors were independently associated with a higher risk of falls : fall as a presenting complaint (odds ratio 4.64 (95% confidence interval 2.59 to 8.33) ; a transfer and mobility score of 3 or 4 (2,10 (1.22 to 3.61)) ; and primary nurses'judgment that a patient was agitated (20.9 (9.62 to 45.62)), needed frequent toileting (2.48 (1.08 to 5.70)), and was visually impaired (3.56 (1.26 to 10.05)). A risk assessment score (range 0-5) was derived by scoring one point for each of these five factors. (...)
Mots-clés Pascal : Chute, Traumatisme, Prédiction, Hôpital, Méthode, Evaluation, Facteur risque, Etude cohorte, Etude cas témoin, Vieillard, Homme
Mots-clés Pascal anglais : Fall, Trauma, Prediction, Hospital, Method, Evaluation, Risk factor, Cohort study, Case control study, Elderly, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0038561
Code Inist : 002B30A01A1. Création : 17/04/1998.