Journal List > Korean J Adult Nurs > v.25(1) > 1094324

Kim, Yoo, Shin, Jeon, Kim, Kang, Choi, Lee, and An: Comparison of the Reliability and Validity of Fall Risk Assessment Tools in Patients with Acute Neurological Disorders

Abstract

Purpose

The aim of the study was to identify the most appropriate fall-risk assessment tool for neurological patients in an acute care setting.

Methods

This descriptive study compared the reliability and validity of three fall-risk assessment tools (Morse Fall Scale, MFS; St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, STRATIFY; Hendrich II Fall Risk Model, HFRM II). We assessed patients who were admitted to the Department of Neurology, Neurosurgery, and Rehabilitation at Asan Medical Center between July 1 and October 31, 2011, using a constructive questionnaire including general and clinical characteristics, and each item from the three tools. We analyzed inter-rater reliability with the kappa value, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools.

Results

The analysis included 1,026 patients, and 32 falls occurred during this study. Inter-rater reliability was above 80% in all three tools. and the sensitivity was 50.0% (MFS), 84.4%(STRATIFY), and 59.4%(HFRM II). The AUC of the STRATIFY was 82.8. However, when the cutoff point was regulated as not 50 but 40 points, the AUC of the MFS was higher at 83.7.

Conclusion

These results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.

Figures and Tables

Figure 1

Receiver operating characteristic curve for the fall risk assessment tool.

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Table 1

General and Clinical Characteristics (N=1,026)

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CNS=central nervous system.

Table 2

Inter-rater Reliability of the Fall Risk Assessment Tool

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MFS=morse fall scale; STRATIFY=St Thomas's risk assessment tool in falling elderly inpatients; HFRM II=Hendrich II fall risk model.

Table 3

Sensitivity, Specificity, and Predictive Value for the Fall Risk Assessment Tool (N=1,026)

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MFS=morse fall scale; STRATIFY=St Thomas's risk assessment tool in falling elderly inpatients; HFRM??Hendrich II fall risk model.

Table 4

AUC and Optimal Cutoff Point for the Fall Risk Assessment Tool

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AUC=area under ROC curve; MFS=morse fall scale; STRATIFY=St Thomas's risk assessment tool in falling elderly inpatients; HFRM II=Hendrich II fall risk model.

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