Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment
INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice .
Using the Downton index to predict those prone to falls in stroke rehabilitation.
BACKGROUND AND PURPOSE Falls are a major complication in inpatient stroke rehabilitation . An important issue in preventive strategies is the early identification of those at risk . This study aim ed at assessing the fall-prediction accuracy of an easily administered fall risk index in stroke rehabilitation . METHODS A consecutive series of 135 patients admitted to a geriatric stroke rehabilitation unit was studied . A score on the Downton fall risk index was obtained from the admission assessment data and used as a predictive indicator of the risk of falls . The patients ' falls were prospect ively recorded during their rehabilitation stay . The correlation between falls and the predicted risk was assessed by means of survival analysis and a multiple regression analysis , adjusting for the time of observation . RESULTS The risk of falls as a function of the time observed was significantly greater among those predicted to be at high risk ( index score > or = 3 ) than among the others ( P = .009 , log-rank test ; odds ratio , 2.9 ) . Furthermore , the number of falls during rehabilitation stay was moderately correlated ( R = .57 ) with the fall risk index sum when adjusted as for the time of observation . The sensitivity of the fall prediction as to outcome was 91 % , whereas the specificity was limited to 27 % . CONCLUSIONS A moderately high correlation was found between the predicted and the observed risk of falls in stroke rehabilitation when the Downton fall risk index was used . However , a low specificity rate limits the accuracy of the prediction
Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment
INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice .