OBJECTIVE: To develop and internally validate a falls prediction tool for people being discharged from inpatient aged care rehabilitation. STUDY DESIGN AND SETTING: Prospective cohort study. Possible predictors of falls were collected for 442 aged care rehabilitation inpatients at two hospitals. RESULTS: One hundred fifty participants fell in the 3 months after discharge from rehabilitation (34% of 438 with follow-up data). Predictors of falls were male gender (odds ratio [OR] 2.32, 95% confidence interval [CI]=1.00-4.03), central nervous system medication prescription (OR 2.04, 95% CI=1.00-3.30), and increased postural sway (OR 1.93, 95% CI=1.00-3.26). This three-variable model was adapted for clinical use by unit weighting (i.e., a score of 1 for each predictor present). The area under the receiver operating characteristic curve (AUC) for this tool was 0.69 (95% CI=0.64-0.74, bootstrap-corrected AUC=0.69). There was no evidence of lack of fit between prediction and observation (Hosmer-Lemeshow P=0.158). CONCLUSION: After external validation, this simple tool could be used to quantify the probability with which an individual will fall in the 3 months after an aged care rehabilitation stay. It may assist in the discharge process by identifying high-risk individuals who may benefit from ongoing assistance or intervention.
AD - The George Institute for Global Health, University of Sydney, PO Box M201, Missenden Road, Sydney NSW 2050, Australia. csherrington@george.org.au AN - 21247735 BT - Journal of Clinical Epidemiology DA - -48222939307 ET - 2011/01/21 LA - eng M1 - 7 N1 - Sherrington, CatherineLord, Stephen RClose, Jacqueline C TBarraclough, ElizabethTaylor, MoragO'Rourke, SandraKurrle, SusanTiedemann, AnneCumming, Robert GHerbert, Robert DResearch Support, Non-U.S. Gov'tValidation StudiesUnited StatesJournal of clinical epidemiologyJ Clin Epidemiol. 2011 Jul;64(7):779-86. Epub 2011 Jan 19. N2 -OBJECTIVE: To develop and internally validate a falls prediction tool for people being discharged from inpatient aged care rehabilitation. STUDY DESIGN AND SETTING: Prospective cohort study. Possible predictors of falls were collected for 442 aged care rehabilitation inpatients at two hospitals. RESULTS: One hundred fifty participants fell in the 3 months after discharge from rehabilitation (34% of 438 with follow-up data). Predictors of falls were male gender (odds ratio [OR] 2.32, 95% confidence interval [CI]=1.00-4.03), central nervous system medication prescription (OR 2.04, 95% CI=1.00-3.30), and increased postural sway (OR 1.93, 95% CI=1.00-3.26). This three-variable model was adapted for clinical use by unit weighting (i.e., a score of 1 for each predictor present). The area under the receiver operating characteristic curve (AUC) for this tool was 0.69 (95% CI=0.64-0.74, bootstrap-corrected AUC=0.69). There was no evidence of lack of fit between prediction and observation (Hosmer-Lemeshow P=0.158). CONCLUSION: After external validation, this simple tool could be used to quantify the probability with which an individual will fall in the 3 months after an aged care rehabilitation stay. It may assist in the discharge process by identifying high-risk individuals who may benefit from ongoing assistance or intervention.
PY - 2011 SN - 1878-5921 (Electronic)0895-4356 (Linking) SP - 779 EP - 86 T2 - Journal of Clinical Epidemiology TI - A simple tool predicted probability of falling after aged care inpatient rehabilitation VL - 64 ER -