Development of a tool for prediction of falls in rehabilitation settings (Predict_FIRST): a prospective cohort study.
OBJECTIVE
To develop and internally validate a simple falls prediction tool for rehabilitation settings.


METHODS
Prospective cohort study.


METHODS
A total of 533 inpatients.


METHODS
Possible predictors of falls were collected from medical records, interview and physical assessment. Falls during inpatient stays were monitored.


RESULTS
Fourteen percent of participants fell. A multivariate model to predict falls included: male gender (odds ratio (OR) 2.70, 95% confidence interval (CI) 1.57-4.64), central nervous system medications (OR 2.50, 95% CI 1.47-4.25), a fall in the previous 12 months (OR 2.21, 95% CI 1.07-4.56), frequent toileting (OR 2.14, 95% CI 1.27-3.62) and tandem stance inability (OR 2.00, 95% CI 1.11-3.59). The area under the curve for this model was 0.74 (95% CI 0.68-0.80). The Predict_FIRST tool is a unit weighted adaptation of this model (i.e. 1 point allocated for each predictor) and its area under the curve was 0.73 (95% CI 0.68-0.79). Predicted and actual falls risks corresponded closely.


CONCLUSIONS
This tool provides a simple way to quantify the probability with which an individual patient will fall during a rehabilitation stay.
Sherrington
Catherine
C
The George Institute for International Health, Missenden Road, Sydney NSW 2050, Australia. csherrington@george.org.au
Lord
Stephen R
SR
Close
Jacqueline C T
JC
Barraclough
Elizabeth
E
Taylor
Morag
M
Oâ Rourke
Sandra
S
Kurrle
Susan
S
Tiedemann
Anne
A
Cumming
Robert G
RG
Herbert
Robert D
RD
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D003071:Cognition; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012047:Rehabilitation Centers; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors