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BMC Health Services Research
Published in: BMC Health Services Research 1/2013

Open Access 01-12-2013 | Research article

Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis

Authors: Marta Aranda-Gallardo, Jose M Morales-Asencio, Jose C Canca-Sanchez, Silvia Barrero-Sojo, Claudia Perez-Jimenez, Angeles Morales-Fernandez, Margarita Enriquez de Luna-Rodriguez, Ana B Moya-Suarez, Ana M Mora-Banderas

Published in: BMC Health Services Research | Issue 1/2013

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Abstract

Background

Falls are a serious problem for hospitalized patients, reducing the duration and quality of life. It is estimated that over 84% of all adverse events in hospitalized patients are related to falls. Some fall risk assessment tools have been developed and tested in environments other than those for which they were developed with serious validity discrepancies. The aim of this review is to determine the accuracy of instruments for detecting fall risk and predicting falls in acute hospitalized patients.

Methods

Systematic review and meta-analysis. Main databases, related websites and grey literature were searched. Two blinded reviewers evaluated title and abstracts of the selected articles and, if they met inclusion criteria, methodological quality was assessed in a new blinded process. Meta-analyses of diagnostic ORs (DOR) and likelihood (LH) coefficients were performed with the random effects method. Forest plots were calculated for sensitivity and specificity, DOR and LH. Additionally, summary ROC (SROC) curves were calculated for every analysis.

Results

Fourteen studies were selected for the review. The meta-analysis was performed with the Morse (MFS), STRATIFY and Hendrich II Fall Risk Model scales. The STRATIFY tool provided greater diagnostic validity, with a DOR value of 7.64 (4.86 - 12.00). A meta-regression was performed to assess the effect of average patient age over 65 years and the performance or otherwise of risk reassessments during the patient’s stay. The reassessment showed a significant reduction in the DOR on the MFS (rDOR 0.75, 95% CI: 0.64 - 0.89, p = 0.017).

Conclusions

The STRATIFY scale was found to be the best tool for assessing the risk of falls by hospitalized acutely-ill adults. However, the behaviour of these instruments varies considerably depending on the population and the environment, and so their operation should be tested prior to implementation. Further studies are needed to investigate the effect of the reassessment of these instruments with respect to hospitalized adult patients, and to consider the real compliance by healthcare personnel with procedures related to patient safety, and in particular concerning the prevention of falls.
Appendix
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Metadata
Title
Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis
Authors
Marta Aranda-Gallardo
Jose M Morales-Asencio
Jose C Canca-Sanchez
Silvia Barrero-Sojo
Claudia Perez-Jimenez
Angeles Morales-Fernandez
Margarita Enriquez de Luna-Rodriguez
Ana B Moya-Suarez
Ana M Mora-Banderas
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2013
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-13-122

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Research article

Social inequalities in patient experiences with general practice and in access to specialists: the population-based HUNT Study

Study protocol

Implementation of a children’s hospital-wide central venous catheter insertion and maintenance bundle

Research article

Trends in dental visiting avoidance due to cost in Australia, 1994 to 2010: an age-period-cohort analysis

Research article

Feasibility of introducing compulsory community health fund in low resource countries: views from the communities in Liwale district of Tanzania

Research article

Decoupling the use and meaning of strategic plans in public healthcare

Research article

Factors associated with evidence-based practice among registered nurses in Sweden: a national cross-sectional study