The FIM instrument to identify patients at risk of falling in geriatric wards: a 10-year retrospective study.
OBJECTIVE
the main objective was to evaluate if the admission functional independence measure (FIM) score could be used to predict the risk of falls in geriatric inpatients.


METHODS
a 10-year retrospective study was performed.


METHODS
the study was conducted in a 298-bed geriatric teaching hospital in Geneva, Switzerland.


METHODS
all patients discharged from the hospital from 1 January 1997 to 31 December 2006 were selected.


METHODS
measures used were FIM scores at admission using the FIM instrument and number of falls extracted from the institution's fall report forms.


RESULTS
during the study period, there were 23,966 hospital stays. A total of 8,254 falls occurred. Of these, 7,995 falls were linked to 4,651 stays. Falls were recorded in 19.4% of hospital stays, with a mean incidence of 7.84 falls per 1,000 patients-days. Although there was a statistically significant relationship between total FIM score, its subscales, and the risk of falling, the sensitivity, specificity, positive predictive value and negative predictive value obtained with receiver operating characteristic curves were insufficient to permit fall prediction. This might be due in part to a non-linear relationship between FIM score and fall risk.


CONCLUSIONS
in this study, the FIM instrument was found to be unable to predict risk of falls in general geriatric wards.
Petitpierre
Nicolas Julien
NJ
Department of Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland. nicolas.petitpierre@hcuge.ch
Trombetti
Andrea
A
Carroll
Iain
I
Michel
Jean-Pierre
JP
Herrmann
François Richard
FR
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006744:Hospital Bed Capacity, 100 to 299; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology