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Risk Score of Papaioannou et al for Predicting Falls in a Hospital Based on a Modification of the STRATIFY Score

Purpose: To evaluate the risk of a patient falling in the hospital based on the risk score of Papaioannou et al.

Description

Papaioannou et al used a weighted score based on the STRATIFY tool to predict the risk of falls by a patient in a hospital. This can help identify patients who may benefit from more aggressive monitoring and management to prevent falls. The authors are from multiple hospitals in Canada.


Parameters:

(1) history of falls

(2) mental status

(3) vision

(4) toileting

(5) transfer and mobility (see table below)

 

Transfer and Mobility

Findings

Points

transfer

unable to perform

0

 

requires major help

1

 

requires minor help (supervision or minor aid from another person)

2

 

independent but may use an aid

3

mobility

immobile

0

 

wheelchair independent

1

 

walks with assistance of a person

2

 

independent but may use a cane or other walking aid

3

 

transfer and mobility subscore =

= (points for transfer) + (points for mobility)

 

Parameter

Finding

Points

history of falls

none

0

 

fall injury reason for admission OR has fallen since admission OR has history of a fall in the last 2 months

1

mental status

normal

0

 

confused OR disoriented OR agitated

1

vision

no problems

0

 

wears glasses continuously OR has blurred vision OR has glaucoma OR has cataracts OR has macular degeneration

1

toileting

no alteration in urination

0

 

frequency OR urgency OR incontinence OR nocturia

1

transfer and mobility

subscore >= 4

0

 

subscore <= 3

1

 

risk score =

= (6 * (points for history)) + (14 * (points for mental status)) + (points for vision) + (2 * (points for toileting)) + (7 * (points for transfer and mobility))

 

Interpretation:

• minimum score: 0

• maximum score: 30

• The higher the score the greater the risk of falling.

• A score >= 9 indicates a patient at risk for falls.

• A score < 9 indicates a low risk for falls.

 

Performance for identifying patients who fall:

• The sensitivity was 91% and the specificity was 60%.


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Specialty

Objective

ICD-10