Article

OBJECTIVES: To test the external validity of 4 approaches to fall prediction in a
rehabilitation setting (Predict_FIRST, Ontario Modified STRATIFY (OMS),
physiotherapists' judgement of fall risk (PT_Risk), and falls in the past year
(Past_Falls)), and to develop and test the validity of a simpler tool for fall
prediction in rehabilitation (Predict_CM2).
PARTICIPANTS: A total of 300
consecutively-admitted rehabilitation inpatients. METHODS: Prospective inception
cohort study. Falls during the rehabilitation stay were monitored. Potential
predictors were extracted from medical records. RESULTS: Forty-one patients (14%)
fell during their rehabilitation stay. The external validity, area under the
receiver operating characteristic curve (AUC), for predicting future fallers was:
0.71 (95% confidence interval (95% CI): 0.61-0.81) for OMS (Total_Score); 0.66
(95% CI: 0.57-0.74) for Predict_FIRST; 0.65 (95% CI 0.57-0.73) for PT_Risk; and
0.52 for Past_Falls (95% CI: 0.46-0.60). A simple 3-item tool (Predict_CM2) was
developed from the most predictive individual items (impaired mobility/transfer
ability, impaired cognition,
and male sex). The accuracy of Predict_CM2 was 0.73
(95% CI: 0.66-0.81), comparable to OMS (Total_Score) (p = 0.52), significantly
better than Predict_FIRST (p = 0.04), and Past_Falls (p < 0.001), and approaching
significantly better than PT_Risk (p = 0.09). CONCLUSION: Predict_CM2 is a
simpler screening tool with similar accuracy for predicting fallers in rehabilitation to OMS (Total_Score) and better accuracy than Predict_FIRST or
Past_Falls. External validation of Predict_CM2 is required.

Langue : ANGLAIS