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Identifying risk of falls in stroke patients

Clinical Rehabilitation: The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitationResearch by Breisinger et al in Pittsburgh, USA, compares the Fall Harm Risk Screen with a tailored assessment tool for stroke patients to identify the most accurate assessment of falls risk.

The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation

Objective: To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen.

Design and setting: Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital.

Participants: Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010.

Results: A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p < 0.001), with area under the curve of 0.73, positive predictive value of 0.29, and negative predictive value of 0.94. For the Fall Harm Risk Screen, area under the curve was 0.56, positive predictive value was 0.19, and negative predictive value was 0.86. Sensitivity and specificity of the SAFR (0.78 and 0.63, respectively) was higher than the Fall Harm Risk Screen (0.57 and 0.48, respectively).

Conclusions: An evidence-derived, population-specific fall risk assessment may more accurately predict fallers than a general fall risk screen for stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted.

Click here to read the full abstract online.

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