The CAREFALL Triage instrument identifying risk factors for recurrent falls in elderly patients.
OBJECTIVE
To validate the CAREFALL Triage Instrument (CTI), a self-administered questionnaire concerning modifiable risk factors for recurrent falls in elderly patients who experienced fall.


METHODS
This study in patients 65 years or older who experienced fall was performed at the accident and emergency department of a tertiary university hospital in the Netherlands. The construct validity was determined in 200 patients and 100 matched controls. The test-retest reliability was determined in 27 patients who answered the CTI twice. The clinical validity was determined in 111 high-risk patients who visited the Fall Prevention Clinic (FPC). The risk factors were as follows: medication, balance and mobility, fear of falling, orthostatic hypotension, mood, high risk of osteoporosis, impaired vision, and urinary incontinence.


RESULTS
Construct Validity Recurrent falls correlated with more risk factors. Age, female gender, and 6 risk factors correlated with recurrent falls. Clinical validity: the agreement between the CTI and FPC was fair for balance and mobility, orthostatic hypotension, and urinary incontinence, moderate for mood, fear of falling, and high risk of osteoporosis, and substantial for "medication and impaired vision. Test-retest reliability: the agreement between the 2 CTIs was substantial for medication, high risk of osteoporosis, moderate for balance and mobility, mood, fair for orthostatic hypotension, impaired vision, and urinary incontinence, and poor for fear of falling.


CONCLUSIONS
The CTI is reliable and valid in assessing risk factors for recurrent falls in elderly patients who experienced fall.
Boele van Hensbroek
Pieter
P
Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam.
van Dijk
Nynke
N
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam.
van Breda
G Fenna
GF
Department of Internal Medicine, Section of Geriatrics, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam.
Scheffer
Alice C
AC
Department of Internal Medicine, Section of Geriatrics, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam.
van der Cammen
Tischa J
TJ
Department of Geriatric Medicine, Erasmus Medical Center, Rotterdam.
Lips
Paul
P
Department of Internal Medicine, Free University Medical Center, Amsterdam.
Goslings
J Carel
JC
Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam.
de Rooij
Sophia E
SE
Department of Internal Medicine, Section of Geriatrics, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam. Electronic address: s.e.derooij@amc.uva.nl.
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014218:Triage