Failure of falls risk screening tools to predict outcome: a prospective cohort study

Emerg Med J. 2018 Jan;35(1):28-32. doi: 10.1136/emermed-2016-206233. Epub 2017 Jun 22.

Abstract

Objective: To compare the Falls Risk for Older Persons-Community Setting Screening Tool (FROP Com Screen) with the Two-Item Screening Tool in older adults presenting to the ED.

Methods: A prospective cohort study, comparing the efficacy of the two falls risk assessment tools by applying them simultaneously in a sample of hospital ED presentations.

Results: Two hundred and one patients over 65 years old were recruited. Thirty-six per cent reported falls in the 6-month follow-up period. The area under the receiver operating characteristic curve was 0.57 (95% CI 0.48 to 0.66) for the FROP Com Screen and 0.54 (95% CI 0.45 to 0.63) for the Two-Item Screening Tool. FROP Com Screen had a sensitivity of 39% (95% CI 0.27 to 0.51) and a specificity of 70% (95% CI 0.61 to 0.78), while the Two-Item Screening Tool had a sensitivity of 48% (95% CI 0.36 to 0.60) and a specificity of 57% (95% CI 0.47 to 0.66).

Conclusion: Both tools have limited predictive ability in the ED setting.

Keywords: accidental falls; emergency department; frailty; geriatrics.

MeSH terms

  • Accidental Falls / prevention & control
  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Geriatric Assessment / methods
  • Humans
  • Male
  • Mass Screening / methods
  • Mass Screening / standards*
  • Prospective Studies
  • Risk Assessment / methods*
  • Risk Assessment / standards
  • Risk Factors