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Analytical Review: Focus on Fall Screening Assessments
Author(s) -
Lee Jacob,
Geller Andrew I.,
Strasser Dale C.
Publication year - 2013
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2013.04.001
Subject(s) - medicine , rehabilitation , acute care , berg balance scale , functional independence measure , medline , physical therapy , health care , population , inpatient care , timed up and go test , fall prevention , risk assessment , emergency medicine , poison control , injury prevention , balance (ability) , computer security , environmental health , political science , computer science , law , economics , economic growth
Background Falls and their associated injuries profoundly impact health outcomes, functional independence, and health care expenses, particularly for the ever‐increasing elderly population. This systematic search and review assessed the current evidence for the role of fall screening assessments. Objective To review the current evidence for fall risk screening assessments in community‐dwelling (outpatient), inpatient medical and surgical wards, inpatient rehabilitation centers, and postrehabilitation outpatient settings. Data Sources MEDLINE and Embase (January 1980 to December 2012). Study Selection Prospective validation studies of acute medical or surgical inpatients, acute rehabilitation inpatients, outpatients who completed acute inpatient rehabilitation, or community‐dwelling elderly. Data Extraction Sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristics with area under the curve. Results We summarized key findings from 6 literature reviews. We then identified 31 articles: 12 studies in community setting, 13 in the acute medical inpatient or surgical inpatient setting, and 6 studies in the rehabilitation setting. Twenty‐two studies not previously reviewed were included, and 9 studies previously reviewed were considered relevant and were included to allow comparison with data from the studies not previously reviewed. Conclusion We recommend consideration of 7 assessment tools to be used in conjunction with overall clinical evaluation to assess falls risk: the Timed Up and Go Test with a cutoff of >12.34 seconds and Functional Gait Assessment among community‐dwelling elderly; St Thomas Risk Assessment Tool in medical inpatients <65 years old and surgical inpatients; Hendrich fall risk model II in medical inpatients; 10‐Minute Walk Test in patients in poststroke rehabilitation; and Berg Balance Scale or the Step Test in patients in poststroke rehabilitation who had fallen during their inpatient stay.