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Developing a Scoring Model to Predict the Risk of Injurious Falls in Elderly Patients: A Retrospective Case–Control Study in Multicenter Acute Hospitals
- Source :
- Clinical Interventions in Aging
- Publication Year :
- 2020
- Publisher :
- Dove, 2020.
-
Abstract
- Purpose Injurious falls seriously threaten the safety of elderly patients. Identifying risk factors for predicting the probability of injurious falls is an important issue that still needs to be solved urgently. We aimed to identify predictors and develop a nomogram for distinguishing populations at high risk of injurious falls from older adults in acute settings. Patients and methods A retrospective case-control study was conducted at three hospitals in Shanghai, China. Elderly patients with injurious falls from January 2014 to December 2018 were taken as cases, and control patients who did not have falls were randomly matched based on the admission date and the department. The data were collected through a medical record review and adverse events system. The original data set was randomly divided into a training set and a validation set at a 7:3 ratio. A nomogram was established based on the results of the univariate analysis and multivariate logistic regression analysis, and its discrimination and calibration were verified to confirm the accuracy of the prediction. The cut-off value of risk stratification was determined to help medical staff identify the high-risk groups. Results A total of 115 elderly patients with injurious falls and 230 controls were identified. History of fractures, orthostatic hypotension, functional status, sedative-hypnotics and level of serum albumin were independent risk factors for injurious falls in elderly patients. The C-indexes of the training and validation sets were 0.874 (95% CI: 0.784-0.964) and 0.847 (95% CI: 0.771-0.924), respectively. Calibration curves were drawn and showed acceptable predictive performance. The cut-off values of the training and validation sets were 146.3 points (sensitivity: 73.7%; specificity: 87.5%) and 157.2 points (sensitivity: 69.2%; specificity: 85.5%), respectively. Conclusion The established nomogram facilitates the identification of high-risk populations among elderly patients, providing a new assessment tool to forecast the individual risk of injurious falls.
- Subjects :
- Male
medicine.medical_specialty
China
Comorbidity
Logistic regression
Risk Assessment
Body Mass Index
nomogram
03 medical and health sciences
Orthostatic vital signs
Fractures, Bone
0302 clinical medicine
elderly adults
Risk Factors
medicine
Humans
Hypnotics and Sedatives
injurious falls
030212 general & internal medicine
Adverse effect
acute hospitalization
Serum Albumin
Original Research
Aged
Retrospective Studies
Aged, 80 and over
Univariate analysis
Training set
business.industry
Medical record
Case-control study
General Medicine
Nomogram
Middle Aged
Physical Functional Performance
Hospitals
Case-Control Studies
Emergency medicine
Wounds and Injuries
Accidental Falls
Female
Geriatrics and Gerontology
business
prediction tool
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 11781998 and 11769092
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- Clinical Interventions in Aging
- Accession number :
- edsair.doi.dedup.....2d417ef88e9b14bc44d43f878f4e4857