Development of a tool for prediction of falls in rehabilitation settings (Predict_FIRST): A prospective cohort study
Catherine Sherrington, Stephen R. Lord, Jacqueline CT Close, Elizabeth Barraclough, Morag Taylor , Sandra O’Rourke , Susan Kurrle, Anne Tiedemann , Robert G Cumming, Robert D. Herbert
Objective: To develop and internally validate a simple falls prediction tool for rehabilitation settings.
Design: Prospective cohort study.
Participants: 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.
Conclusion: This tool provides a simple way to quantify the probability with which an individual patient will fall during a rehabilitation stay.