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首页> 外文期刊>Journal of orthopaedic nursing >A pilot investigation of the efficacy of falls risk assessment tools and prevention strategies in an elderly hip fracture population
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A pilot investigation of the efficacy of falls risk assessment tools and prevention strategies in an elderly hip fracture population

机译：对老年人髋部骨折人群跌倒风险评估工具的有效性和预防策略的初步调查

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Background The importance of reducing the number of falls was highlighted by the UK National Service Framework for Older People [Department of Health, 2001]. In response falls risk assessment tools have been developed and implemented into clinical practice. However their predictive accuracy is generally unsubstantiated.Aims The study aimed to investigate the predictive accuracy of the Fall Risk Assessment Scale for the Elderly (FRASE) and St. Thomas's Risk Assessment Tool (STRATIFY) and determine if falls prevention strategies reduced the number of falls in hip fracture patients.Design A quasi-experimental design compared the incidence of falls between retrospective (n = 30) and prospective (n - 60) groups of hip fracture patients admitted to an acute NHS hospital. Receiver Operator Characteristic (ROC) calculated the predictive accuracy of both FRASE and STRATIFY in identifying the fall risk status of the sample. Also the inter-rater reliability of the two tools was tested.Results Inter-rater reliability for both FRASE and STRATIFY was high with correlation coefficients of 0.964 and 0.836, respectively, and p values of 0.001. Two patients fell in the prospective group and 3 in the retrospective group. There was no significant difference in the number of falls between the groups with the p value being 0.204. Both FRASE and STRATIFY were found to have poor predictive accuracy with ROC scores of 0.560 and 0.629, respectively, for the prospective group. The tools also demonstrated poor predictive accuracy with the retrospective group with a ROC score of 0.370 for FRASE and 0.463 for STRATIFY.Conclusions and relevance Although the study demonstrated good inter-rater reliability of both tools the level of predictive accuracy was poor. Both tools were demonstrated to over predict the risk of patients falling. At face value it would appear preferable for a tool to over predict risk of falling rather than under predicting, however this must be viewed in the context of finite resources. It is recommended that further research is needed to manipulate the threshold level for risk of falling with both tools and to ascertain if the inclusion of extrinsic factors would improve their predictive accuracy.
机译：背景技术英国国家老年人服务框架[卫生部，2001]强调了减少跌倒次数的重要性。为了应对跌倒，已经开发了风险评估工具并将其应用于临床实践。然而，他们的预测准确性通常没有根据。目的该研究旨在调查老年人跌倒风险评估量表（FRASE）和圣托马斯风险评估工具（STRATIFY）的预测准确性，并确定跌倒预防策略是否减少了跌倒次数设计一项准实验设计比较了入住急性NHS医院的髋部骨折患者的回顾性（n = 30）组与预期（n-60）组之间跌倒的发生率。接收方操作员特征（ROC）计算了FRASE和STRATIFY在识别样品跌落风险状态时的预测准确性。结果还对FRASE和STRATIFY的评估者间可靠性进行了测试，相关系数分别为0.964和0.836，p值为0.001。预期组有2例患者，回顾组有3例患者。两组之间的跌倒次数没有显着差异，p值为0.204。对于预期组，发现FRASE和STRATIFY的预测准确性均较差，ROC分数分别为0.560和0.629。该工具还显示出较差的预测准确性，回顾性组的FRASE的ROC得分为0.370，STRATIFY的ROC得分为0.463。结论和相关性尽管这项研究表明这两种工具的评估者间信度都很好，但预测的准确性却很差。两种工具都被证明可以过度预测患者跌倒的风险。从表面上看，使用工具高估跌倒的风险而不是低估似乎是可取的，但是必须在有限资源的背景下加以考虑。建议需要进一步研究，以同时使用两种工具来控制跌倒风险的阈值水平，并确定是否包含外部因素会提高其预测准确性。

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