LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, S. Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Via Circondaria 29, 42122 Correggio, Italy.
Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy.
Int J Environ Res Public Health. 2021 Feb 4;18(4):1444. doi: 10.3390/ijerph18041444.
(1) Background: Falls are a dangerous adverse event in patients discharged from rehabilitation units, with the risk of falling being higher in the first weeks after discharge. In this study, we assessed the predictive performance of the Hendrich Fall Risk Model II tool (HIIFRM) when administered before discharging patients to their home from rehabilitative units in orthopedic (OR), neurologic (NR) and pulmonary (PR) rehabilitation wards. (2) Methods: Over a 6-month period, all adult patients who returned home after discharge were assessed by HIIFRM. At six months from discharge the occurrence of falls was obtained by performing a structured survey. The HIIFRM predictive performance was determined by the area under the ROC curve (AUC), sensitivity (Se) and specificity (Sp) for the whole sample and split by ward. (3) Results: 85 of 141 discharged patients were living at home and agreed to take part in the survey. Of these, 19 subjects fell, 6 suffered fractures or head traumas and 5 were hospitalized. The AUC was 0.809 (95% CI: 0.656-0.963), Se was 0.67 (0.30-0.93) and Sp was 0.79 (0.63-0.90) for OR patients. (4) Conclusions: Our preliminary results support the use of HIIFRM as a tool to be administered to OR patients at discharge and provides data for the design of a large study of predictive ability.
(1) 背景：跌倒在从康复病房出院的患者中是一种危险的不良事件，出院后第一周内跌倒的风险更高。在这项研究中，我们评估了 Hendrich 跌倒风险模型 II 工具（HIIFRM）在将患者从矫形（OR）、神经（NR）和肺（PR）康复病房出院回家前使用时的预测性能。
(2) 方法：在 6 个月的时间内，所有从康复病房出院后回家的成年患者都接受了 HIIFRM 评估。在出院后 6 个月，通过进行结构化调查获得跌倒的发生情况。通过 ROC 曲线下面积（AUC）、敏感性（Se）和特异性（Sp）来确定 HIIFRM 的预测性能，整体样本和按病房进行了划分。
(3) 结果：141 名出院患者中有 85 名居住在家庭中并同意参加调查。其中，19 名患者跌倒，6 名患者骨折或头部受伤，5 名患者住院。OR 患者的 AUC 为 0.809（95%CI：0.656-0.963），Se 为 0.67（0.30-0.93），Sp 为 0.79（0.63-0.90）。
(4) 结论：我们的初步结果支持将 HIIFRM 用作出院时 OR 患者的评估工具，并为预测能力的大型研究设计提供了数据。
