Fall risk assessment measures: An analytic review
Fall risk assessment measures: An analytic review
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DOI：
10.1093/gerona/56.12.m761
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发表时间：
2001-12-01
影响因子：
5.1
通讯作者：
Rubenstein, LZ
中科院分区：
文献类型：
--
作者：
Perell, KL;Nelson, A;Rubenstein, LZ
背景临床医生通常不知道许多现有的用于识别跌倒风险的量表，并且不确定如何选择合适的量表。我们的目的是总结现有的跌倒风险评估量表，使更多的知情选择，关于他们的使用。经过系统的文献检索，21篇文章发表于1984年至2000年，描述了20个跌倒风险评估的内容和验证进行了独立的审查，由一个小组的五名审查员使用标准化的审查表格。14份为机构护理评估量表，6份为功能评估量表。大多数量表是为老年人制定的。主要用于医院或疗养院。评估的患者特征在护理评估表中非常相似。完成表格的时间从不到1分钟到80分钟不等。对于那些报告了诊断准确性的量表，灵敏度为43%至100%（中位数= 80%），特异性为38%至96%（中位数= 75%）。几个具有上级诊断特征的量表被确定。大量的跌倒风险评估工具是现成的，并评估类似的患者特征。虽然他们的诊断准确性和整体的有用性表现出广泛的变异性，有几个尺度，可以使用的信心，作为一个有效的福尔斯预防计划的一部分。因此，设施不太需要发展自己的规模。继续开发针对单个设施的跌倒风险评估可能会适得其反，因为不同设施的评分不具有可比性。
Background. Clinicians are often unaware of the many existing scales for identifying fall risk and are uncertain about how to select an appropriate one. Our purpose was to summarize existing fall risk assessment scales to enable more informed choices regarding their use.Methods. After a systematic literature search, 21 articles published from 1984 through 2000 describing 20 fall risk assessments were reviewed independently for content and validation by a panel of five reviewers using a standardized review form. Fourteen were institution-focused nursing assessment scales, and six were functional assessment scales.Results. The majority of the scales were developed for elderly populations. mainly in hospital or nursing home settings. The patient characteristics assessed were quite similar across the nursing assessment forms. The time to complete the form varied from less than I minute to 80 minutes. For those scales with reported diagnostic accuracy, sensitivity varied from 43% to 100% (median = 80%), and specificity varied from 38% to 96% (median = 75%). Several scales with superior diagnostic characteristics were identified.Conclusions. A substantial number of fall risk assessment tools are readily available and assess similar patient characteristics. Although their diagnostic accuracy and overall usefulness showed wide variability, there are several scales that can be used with confidence as part of an effective falls prevention program. Consequently, there should be little need for facilities to develop their own scales. To continue to develop fall risk assessments unique to individual facilities may be counterproductive because scores will not be comparable across facilities.