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Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study

Background: Harmful in-hospital falls with subsequent injuries often cause longer stays and subsequently higher costs. Early identification of fall risk may help in establishing preventive strategies. Objective: To assess the predictive ability of different clinical scores including the Post-acute c...

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Autores principales: Siegwart, Jennifer, Spennato, Umberto, Lerjen, Nathalie, Mueller, Beat, Schuetz, Philipp, Koch, Daniel, Struja, Tristan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298410/
https://www.ncbi.nlm.nih.gov/pubmed/37367092
http://dx.doi.org/10.3390/geriatrics8030060
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author Siegwart, Jennifer
Spennato, Umberto
Lerjen, Nathalie
Mueller, Beat
Schuetz, Philipp
Koch, Daniel
Struja, Tristan
author_facet Siegwart, Jennifer
Spennato, Umberto
Lerjen, Nathalie
Mueller, Beat
Schuetz, Philipp
Koch, Daniel
Struja, Tristan
author_sort Siegwart, Jennifer
collection PubMed
description Background: Harmful in-hospital falls with subsequent injuries often cause longer stays and subsequently higher costs. Early identification of fall risk may help in establishing preventive strategies. Objective: To assess the predictive ability of different clinical scores including the Post-acute care discharge (PACD) score and nutritional risk screening score (NRS), and to develop a new fall risk score (FallRS). Methods: A retrospective cohort study of medical in-patients of a Swiss tertiary care hospital from January 2016 to March 2022. We tested the ability of the PACD score, NRS and FallRS to predict a fall by using the area under curve (AUC). Adult patients with a length of stay of ≥ 2 days were eligible. Results: We included 19,270 admissions (43% females; median age, 71) of which 528 admissions (2.74%) had at least one fall during the hospital stay. The AUC varied between 0.61 (95% confidence interval (CI), 0.55–0.66) for the NRS and 0.69 (95% CI, 0.64–0.75) for the PACD score. The combined FallRS score had a slightly better AUC of 0.70 (95% CI, 0.65–0.75) but was more laborious to compute than the two other scores. At a cutoff of 13 points, the FallRS had a specificity of 77% and a sensitivity of 49% in predicting falls. Conclusions: We found that the scores focusing on different aspects of clinical care predicted the risk of falls with fair accuracy. A reliable score with which to predict falls could help in establishing preventive strategies for reducing in-hospital falls. Whether or not the scores presented have better predictive ability than more specific fall scores do will need to be validated in a prospective study.
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spelling pubmed-102984102023-06-28 Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study Siegwart, Jennifer Spennato, Umberto Lerjen, Nathalie Mueller, Beat Schuetz, Philipp Koch, Daniel Struja, Tristan Geriatrics (Basel) Article Background: Harmful in-hospital falls with subsequent injuries often cause longer stays and subsequently higher costs. Early identification of fall risk may help in establishing preventive strategies. Objective: To assess the predictive ability of different clinical scores including the Post-acute care discharge (PACD) score and nutritional risk screening score (NRS), and to develop a new fall risk score (FallRS). Methods: A retrospective cohort study of medical in-patients of a Swiss tertiary care hospital from January 2016 to March 2022. We tested the ability of the PACD score, NRS and FallRS to predict a fall by using the area under curve (AUC). Adult patients with a length of stay of ≥ 2 days were eligible. Results: We included 19,270 admissions (43% females; median age, 71) of which 528 admissions (2.74%) had at least one fall during the hospital stay. The AUC varied between 0.61 (95% confidence interval (CI), 0.55–0.66) for the NRS and 0.69 (95% CI, 0.64–0.75) for the PACD score. The combined FallRS score had a slightly better AUC of 0.70 (95% CI, 0.65–0.75) but was more laborious to compute than the two other scores. At a cutoff of 13 points, the FallRS had a specificity of 77% and a sensitivity of 49% in predicting falls. Conclusions: We found that the scores focusing on different aspects of clinical care predicted the risk of falls with fair accuracy. A reliable score with which to predict falls could help in establishing preventive strategies for reducing in-hospital falls. Whether or not the scores presented have better predictive ability than more specific fall scores do will need to be validated in a prospective study. MDPI 2023-06-01 /pmc/articles/PMC10298410/ /pubmed/37367092 http://dx.doi.org/10.3390/geriatrics8030060 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Siegwart, Jennifer
Spennato, Umberto
Lerjen, Nathalie
Mueller, Beat
Schuetz, Philipp
Koch, Daniel
Struja, Tristan
Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study
title Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study
title_full Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study
title_fullStr Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study
title_full_unstemmed Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study
title_short Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study
title_sort prediction of in-hospital falls using nrs, pacd score and fallrs: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298410/
https://www.ncbi.nlm.nih.gov/pubmed/37367092
http://dx.doi.org/10.3390/geriatrics8030060
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