Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
J Clin Epidemiol. 2010 Nov;63(11):1242-8. doi: 10.1016/j.jclinepi.2009.12.012. Epub 2010 Apr 7.
The fall risk profile developed in the Longitudinal Aging Study Amsterdam (LASA) identifies community-dwelling elderly at high risk for recurrent falling. This study assessed the predictive validity of this profile in older persons seeking care after a fall.
The LASA fall risk profile was completed for 408 persons of 65 years and older who consulted the emergency department or general practitioner after a fall. Falls were prospectively reported with a calendar during 1 year. Recurrent falling was defined as ≥ 2 falls within a period of 6 months.
During 1 year of followup, 76 (18.6%) participants became recurrent fallers. The area under the receiver operating characteristic curve was 0.65 (95% confidence interval [95% CI]: 0.58-0.72). At a cutoff value of 8, the sensitivity was 56.6% (CI: 51.8-61.4), the specificity was 71.4% (CI: 67.0-75.8), the positive predictive value was 34.1% (CI: 29.5-38.7), and the negative predictive value was 85.6% (CI: 82.2-89.0).
The discriminative ability of the LASA fall risk profile was moderate. The predictive validity of the LASA fall risk profile to identify recurrent fallers is limited among older persons who consulted the emergency department or general practitioner after a fall.
在阿姆斯特丹纵向老龄化研究(LASA)中开发的跌倒风险评估工具可识别出有反复跌倒高风险的社区居住老年人。本研究评估了该评估工具在跌倒后寻求医疗护理的老年人中的预测有效性。
为 408 名年龄在 65 岁及以上、跌倒后咨询急诊部门或全科医生的老年人完成了 LASA 跌倒风险评估。在 1 年内通过日历前瞻性报告跌倒情况。定义反复跌倒为在 6 个月内≥2 次跌倒。
在 1 年的随访期间,76 名(18.6%)参与者成为反复跌倒者。受试者工作特征曲线下面积为 0.65(95%置信区间[95%CI]:0.58-0.72)。在截断值为 8 时,敏感性为 56.6%(CI:51.8-61.4),特异性为 71.4%(CI:67.0-75.8),阳性预测值为 34.1%(CI:29.5-38.7),阴性预测值为 85.6%(CI:82.2-89.0)。
LASA 跌倒风险评估工具的区分能力为中等。对于跌倒后咨询急诊部门或全科医生的老年人,LASA 跌倒风险评估工具对识别反复跌倒者的预测有效性有限。