title: Development of a tool for prediction of falls in rehabilitation settings (Predict_FIRST): a prospective cohort study.
abstract: 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.
authors.affiliation: The George Institute for International Health, Missenden Road, Sydney NSW 2050, Australia. csherrington@george.org.au
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barraclough
authors.forename: Morag
authors.initials: M
authors.lastname: Taylor
authors.forename: Sandra
authors.initials: S
authors.lastname: Oâ Rourke
authors.forename: Susan
authors.initials: S
authors.lastname: Kurrle
authors.forename: Anne
authors.initials: A
authors.lastname: Tiedemann
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Robert D
authors.initials: RD
authors.lastname: Herbert
mesh_terms: 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