Effectiveness of the Timed Up and Go (TUG) and the Chair test as screening tools for geriatric fall risk assessment in the ED

Objective: We sought to evaluate the effectiveness of the Timed Up and Go (TUG) and the Chair test as screening tools in the Emergency Department (ED), stratified by sex. Methods: This prospective cohort study was conducted at a Level 1 Trauma center. After consent, subjects performed the TUG and the Chair test. Subjects were contacted for phone follow-up and asked to self-report interim falling. Results: Data from 192 subjects were analyzed. At baseline, 71.4% ( n 137) screened positive for increased falls risk based on the TUG evaluation, and 77.1% (n 148) scored below average on the Chair test. There were no differences by patient sex. By the six-month evaluation 51 (26.6%) study participants reported at least one fall. Females reported a non-significant higher prevalence of falls compared to males (29.7% versus 22.2%, p 0.24). TUG test had a sensitivity of 70.6% (95% CI: 562%-82.5%), a specificity of 28.4% (95% CI: 21.1%-36.6%), a positive predictive (PP) value 26.3% (95% CI: 19.1%-34.5%) and a negative predictive (NP) value of 72.7% (95% CI: 59.0%-83.9%). Similar results were observed with the Chair test. It had a sensitivity of 78.4% (95% CI: 64.7%-88.7%), a specificity of 23.4% (95% CI: 16.7%-313%), a PP value 27.0% (95% CI: 20.1%-34.9%) and a NP value of 75.0% (95% CI: 59.7%-86.8%). No significant differences were observed between sexes. Conclusions: There were no sex specific significant differences in TUG or Chair test screening performance. Neither test performed well as a screening tool for future falls in the elderly in the ED setting. (C) 2018 Elsevier Inc. All rights reserved.