Significant fall risk factors in the personal history of in-patients with neurological disease

Česká verzia

Authors: M. Miertová ¹; I. Bóriková ¹; M. Grendár ²; J. Madleňák ¹; M. Tomagová ¹; K. Žiaková ¹
Authors place of work: Ústav ošetrovateľstva, Jesseniova LF UK v Martine, Slovensko ¹; Martinské centrum pre biomedicínu (BioMed), Jesseniova LF UK v Martine, Slovensko ²
Published in the journal: Cesk Slov Neurol N 2019; 82(6): 649-654
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2019649

Summary

Aim: To identify significant fall risk factors in in-patients with neurological disease and to assess their predictive value.

Patients and methods: 298 in-patients were included into the prospective study. Fall risk factors were assessed through analysis of medical records, and fall risk score was identified through the Morse Fall Scale (MFS) screening during admission to the hospital. A multidimensional logistic regression model was used to identify significant fall risk factors. The relative risk of falling was quantified using the odds ratio (OR). Receiver operating characteristic (ROC) curve with area under the curve (AUC) was used to assess the predictive value of selected fall risk factors.

Results: The most frequent fall risk factors were in the sample (N = 298): gait, balance and mobility disorders (80.9%), pharmacotherapy (57.0%), associated disease (52.7%), and visual impairment (52.3%). The average fall risk score was at medium risk level (MFS score of 44.2 ± 21.2). The highest risk of falling was seen in risk factors: associated disease (OR = 5.452; CI 1.693– 20.033; P = 0.007), medical diagnosis G35– G37 (OR = 4.597, CI 1.273– 17.481; P = 0.021), visual impairment (OR = 3.494; CI 1.281– 10.440; P = 0.019), and fall risk level according to the MFS at admission (OR = 1.18; CI 1.135– 1.252; P < 0.001). The predictive value of risk factors expressed by the ROC curve was AUC = 0.934.

Conclusions: Identifying fall risk factors is the first step in effective prevention of this adverse event during hospitalization. Targeted fall risk screening will allow planning and implementation of interventions to minimize the risk of falling.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

患有神经系统疾病的患者的个人病史中存在重要的跌倒危险因素

目的：确定患有神经系统疾病的住院患者的重大跌倒危险因素，并评估其预测价值。

患者和方法：298名住院患者纳入前瞻性研究。通过对病历的分析来评估跌倒风险因素，并在入院期间通过莫尔斯跌倒量表（MFS）筛查来确定跌倒风险评分。多维逻辑回归模型用于确定重大的跌倒风险因素。使用比值比（OR）量化跌倒的相对风险。受试者工作特征（ROC）曲线及其下的面积（AUC）用于评估所选跌倒危险因素的预测值。

结果：最常见的跌倒风险因素是样本（N = 298）：步态，平衡和活动障碍（80.9％），药物治疗（57.0％），相关疾病（52.7％）和视力障碍（52.3％）。平均跌倒风险评分处于中等风险水平（MFS评分为44.2±21.2）。跌倒的最高风险发生于危险因素：相关疾病（OR = 5.452； CI 1.693-20.033； P = 0.007），医学诊断G35-G37（OR = 4.597，CI 1.273-17.481； P = 0.021），视力障碍（OR = 3.494； CI 1.281– 10.440； P = 0.019），并根据入院时的MFS下降风险水平（OR = 1.18； CI 1.135– 1.252； P <0.001）。 ROC曲线表示的危险因素的预测值为AUC = 0.934。

结论：识别跌倒危险因素是有效预防住院期间这种不良事件的第一步。有针对性的跌倒风险筛查将有助于规划和实施干预措施，以最大程度地降低跌倒的风险。

关键词：跌倒–危险因素–筛查–神经科–患者–住院

Keywords:

fall – risk factor – patient – screening – Neurology – hospitalization

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