“计时起立行走”（TUG）和椅子测试作为急诊科老年跌倒风险评估筛查工具的有效性。

Effectiveness of the "Timed Up and Go" (TUG) and the Chair test as screening tools for geriatric fall risk assessment in the ED.

机构信息

Department of Emergency and Hospital Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA, United States.

Department of Surgery, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA, United States.

出版信息

Am J Emerg Med. 2019 Mar;37(3):457-460. doi: 10.1016/j.ajem.2018.06.015. Epub 2018 Jun 7.

DOI:10.1016/j.ajem.2018.06.015

PMID:29910184

Abstract

OBJECTIVE

We sought to evaluate the effectiveness of the "Timed Up and Go" (TUG) and the Chair test as screening tools in the Emergency Department (ED), stratified by sex.

METHODS

This prospective cohort study was conducted at a Level 1 Trauma center. After consent, subjects performed the TUG and the Chair test. Subjects were contacted for phone follow-up and asked to self-report interim falling.

RESULTS

Data from 192 subjects were analyzed. At baseline, 71.4% (n = 137) screened positive for increased falls risk based on the TUG evaluation, and 77.1% (n = 148) scored below average on the Chair test. There were no differences by patient sex. By the six-month evaluation 51 (26.6%) study participants reported at least one fall. Females reported a non-significant higher prevalence of falls compared to males (29.7% versus 22.2%, p = 0.24). TUG test had a sensitivity of 70.6% (95% CI: 56.2%-82.5%), a specificity of 28.4% (95% CI: 21.1%-36.6%), a positive predictive (PP) value 26.3% (95% CI: 19.1%-34.5%) and a negative predictive (NP) value of 72.7% (95% CI: 59.0%-83.9%). Similar results were observed with the Chair test. It had a sensitivity of 78.4% (95% CI: 64.7%-88.7%), a specificity of 23.4% (95% CI: 16.7%-31.3%), a PP value 27.0% (95% CI: 20.1%-34.9%) and a NP value of 75.0% (95% CI: 59.7%-86.8%). No significant differences were observed between sexes.

CONCLUSIONS

There were no sex specific significant differences in TUG or Chair test screening performance. Neither test performed well as a screening tool for future falls in the elderly in the ED setting.

摘要

目的

我们旨在评估“计时起立行走”（TUG）和椅子测试作为急诊科（ED）筛查工具的有效性，并按性别进行分层。

方法

本前瞻性队列研究在一家 1 级创伤中心进行。获得同意后，受试者进行 TUG 和椅子测试。通过电话联系受试者进行随访，并要求他们报告临时跌倒情况。

结果

对 192 名受试者的数据进行了分析。在基线时，根据 TUG 评估，71.4%（n=137）筛查出跌倒风险增加，77.1%（n=148）在椅子测试中得分低于平均水平。患者性别之间没有差异。在 6 个月的评估中，有 51 名（26.6%）研究参与者报告至少发生了一次跌倒。与男性相比，女性报告跌倒的发生率较高，但无统计学意义（29.7%比 22.2%，p=0.24）。TUG 测试的敏感性为 70.6%（95%可信区间：56.2%-82.5%），特异性为 28.4%（95%可信区间：21.1%-36.6%），阳性预测值为 26.3%（95%可信区间：19.1%-34.5%），阴性预测值为 72.7%（95%可信区间：59.0%-83.9%）。椅子测试也得到了类似的结果。它的敏感性为 78.4%（95%可信区间：64.7%-88.7%），特异性为 23.4%（95%可信区间：16.7%-31.3%），阳性预测值为 27.0%（95%可信区间：20.1%-34.9%），阴性预测值为 75.0%（95%可信区间：59.7%-86.8%）。性别之间没有观察到显著差异。