title: Pro-Active Fall-Risk Management is Mandatory to Sustain in Hospital-Fall Prevention in Older Patients--Validation of the LUCAS Fall-Risk Screening in 2,337 Patients.
abstract: OBJECTIVE
  Prevention of in-hospital falls contributes to improvement of patient safety. However, the identification of high-risk patients remains a challenge despite knowledge of fall-risk factors. Hence, objective was to prospectively validate the performance of the LUCAS (Longitudinal Urban Cohort Ageing Study) fall-risk screening, based on routine data (fall history, mobility, mental status) and applied by nurses.
  
  
  METHODS
  Observational study comparing two groups of patients who underwent different fall-risk screenings; the LUCAS screening (2010 - 2011) and the STRATIFY (St. Thomas's Risk Assessment Tool In Falling Elderly Inpatients) (2004 - 2006).
  
  
  METHODS
  Urban teaching hospital.
  
  
  METHODS
  Consecutively hospitalized patients (≥ 65 years old) were screened on admission; LUCAS n = 2,337, STRATIFY n = 4,735.
  
  
  METHODS
  The proportions of fallers were compared between the STRATIFY and the LUCAS time periods. The number of fallers expected was compared to that observed in the LUCAS time period. Standardized fall-incidence recording included case-note checks for unreported falls. Plausibility checks of fall-risk factors and logistic regression analysis for variable fall-risk factors were performed.
  
  
  RESULTS
  The proportions of fallers during the two time periods were LUCAS n = 291/2,337 (12.5%) vs. STRATIFY n = 508/4,735 (10.7%). After adjustment for risk-factor prevalence, the proportion of fallers expected was 14.5% (334/2,337), the proportion observed was 12.5% (291/2,337) (p = 0.038).
  
  
  CONCLUSIONS
  In-hospital fall prevention including systematic use of the LUCAS fall-risk screening reduced the proportion of fallers compared to that expected from the patients' fall-risk profile. Raw proportions of fallers are not suitable to evaluate fall prevention in hospital because of variable prevalence of patients' fall-risk factors over time. Continuous communication, education and training is needed to sustain in-hospital falls prevention.
authors.affiliation: Lilli Neumann, Albertinen-Haus, Geriatrics Centre, Scientific Department at the University of Hamburg, Sellhopsweg 18-22, D-22459 Hamburg, Germany, Tel.: ++49-40-5581-1692; Fax: ++49-40-5581-1874; E-Mail: lilli.neumann@albertinen.de.
authors.forename: V S
authors.initials: VS
authors.lastname: Hoffmann
authors.forename: L
authors.initials: L
authors.lastname: Neumann
authors.forename: S
authors.initials: S
authors.lastname: Golgert
authors.forename: W
authors.initials: W
authors.lastname: von Renteln-Kruse
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006760:Hospitalization; D006761:Hospitals; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D061214:Patient Safety; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors