Agreement and predictive performance of fall risk assessment methods and factors associated with falls in hospitalized older adults: A longitudinal study

Falls in hospitalized older adults are of concern and, despite the availability of fall risk assessment methods and knowledge about factors associated with falls, their validity and agreement remain poorly investigated. In a prospective study, we enrolled 102 hospitalized older adults (median [P25-P75]) 67 (64-73) years, 52 [51%] men, length of stay 20 [8-41] days). Fall risk was assessed at hospital admission using the Functional Independence Measure; Morse Fall Scale; St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients; Johns Hopkins Fall Risk Assessment Tool; and polypharmacy. The St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients method showed the highest predictive performance (accuracy 92%) for the identification of fallers during hospitalization. A slightly better-then-chance agreement was estimated between all methods (Light's k = 0.120). Fall risk assessment methods and factors associated with falls should not be used interchangeably as their overall and pairwise agreement are fair at best.

Automated summary

Falls in hospitalized older adults are a concern, but the validity and agreement of fall risk assessment methods and factors associated with falls have not been well investigated.