A simple tool predicted probability of falling after aged care inpatient rehabilitation.
OBJECTIVE
To develop and internally validate a falls prediction tool for people being discharged from inpatient aged care rehabilitation.


METHODS
Prospective cohort study. Possible predictors of falls were collected for 442 aged care rehabilitation inpatients at two hospitals.


RESULTS
One hundred fifty participants fell in the 3 months after discharge from rehabilitation (34% of 438 with follow-up data). Predictors of falls were male gender (odds ratio [OR] 2.32, 95% confidence interval [CI]=1.00-4.03), central nervous system medication prescription (OR 2.04, 95% CI=1.00-3.30), and increased postural sway (OR 1.93, 95% CI=1.00-3.26). This three-variable model was adapted for clinical use by unit weighting (i.e., a score of 1 for each predictor present). The area under the receiver operating characteristic curve (AUC) for this tool was 0.69 (95% CI=0.64-0.74, bootstrap-corrected AUC=0.69). There was no evidence of lack of fit between prediction and observation (Hosmer-Lemeshow P=0.158).


CONCLUSIONS
After external validation, this simple tool could be used to quantify the probability with which an individual will fall in the 3 months after an aged care rehabilitation stay. It may assist in the discharge process by identifying high-risk individuals who may benefit from ongoing assistance or intervention.
The George Institute for Global Health, University of Sydney, PO Box M201, Missenden Road, Sydney NSW 2050, Australia. csherrington@george.org.au
Catherine
C
Sherrington
Stephen R
SR
Lord
Jacqueline C T
JC
Close
Elizabeth
E
Barraclough
Morag
M
Taylor
Sandra
S
O'Rourke
Susan
S
Kurrle
Anne
A
Tiedemann
Robert G
RG
Cumming
Robert D
RD
Herbert
D000058:Accidental Falls; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011336:Probability; D012047:Rehabilitation Centers; D018570:Risk Assessment