Comparison of fall risk assessment scales in inpatients–a quality improvement study

Falls are common and complex geriatric syndrome that can lead to loss of function, morbidity and even mortality. Risk assessment scales are frequently used to predict and prevent expected falls. This study aims to determine the risk factors for falls in hospitalized patients aged 18 years and over and to determine the sensitivity and specificity, positive and negative predictive values of the scales. Furthermore, Johns Hopkins Fall Risk Assessment Tool and the STRATIFY Risk Assessment Tool were adapted to Turkish and their reliability and validity assessments were made. 391 patients were included in the study, fall risk assessment form, Hendrich II, Johns Hopkins and STRATIFY scales were applied to each patient, and Timed Get Up and Go Test was performed to eligible patients. According to the analysis, falls occurred in 16 (4%) patients. Presence of emergency hospitalization, Charlson comorbidity index score, presence of hospitalization in internal medicine wards, number of medications, number of days of hospitalization, Clinical Frailty Scale and FRAIL scale scores, diagnosis of diabetes and leukemia, history of falling in the last month, neurological disease, delirium/agitation, visual impairment , walking aid use, fear of falling, and presence of caregiver were found to be significantly higher in the fallers group in univariate analyses. Turkish versions of the JHFRAT and STRATIFY scales were found to have high test-retest reliability and moderate inter-observer reliability. The validity of both scales was demonstrated, and the reliability was moderately but statistically significant. In logistic regression analysis, STRATIFY (OR = 8.63, 95% CI: 2.75-27.1) and JHFRAT (OR = 10.08, 95% CI: 1.18-86.15) tools were significantly associated with falls. According to the ROC analysis, the JHFRAT scale was found to have the highest predictive value, and the scale can be used as a risk assessment scale for hospitalized patients.