L. Neumann

In-hospital fall-risk screening in 4,735 geriatric patients from the LUCAS project

ObjectivesIn-hospital falls in older patients are frequent, but the identification of patients at risk of falling is challenging. Aim of this study was to improve the identification of high-risk patients. Therefore, a simplified screening-tool was developed, validated, and compared to the STRATIFY predictive accuracy.DesignRetrospective analysis of 4,735 patients; evaluation of predictive accuracy of STRATIFY and its single risk factors, as well as age, gender and psychotropic medication; splitting the dataset into a learning and a validation sample for modelling fall-risk screening and independent, temporal validation.SettingGeriatric clinic at an academic teaching hospital in Hamburg, Germany.Participants4,735 hospitalised patients ≥65 years.MeasurementsSensitivity, specificity, positive and negative predictive value, Odds Ratios, Youden-Index and the rates of falls and fallers were calculated.ResultsThere were 10.7% fallers, and the fall rate was 7.9/1,000 hospital days. In the learning sample, mental alteration (OR 2.9), fall history (OR 2.1), and insecure mobility (Barthel-Index items ‘transfer’ + ‘walking’ score = 5, 10 or 15) (OR 2.3) had the most strongest association to falls. The LUCAS Fall-Risk Screening uses these risk factors, and patients with ≥2 risk factors contributed to the high-risk group (30.9%). In the validation sample, STRATIFY SENS was 56.8, SPEC 59.6, PPV 13.5 and NPV 92.6 vs. LUCAS Fall-Risk Screening was SENS 46.0, SPEC 71.1, PPV 14.9 and NPV 92.3.ConclusionsBoth the STRATIFY and the LUCAS Fall-Risk Screening showed comparable results in defining a high-risk group. Impaired mobility and cognitive status were closely associated to falls. The results do underscore the importance of functional status as essential fall-risk factor in older hospitalised patients.

P214: Multi-component health PROmotion and primary preventive intervention programmes and LONG-term evaluation in HEALTHy community-dwelling senior citizens (PROLONG-HEALTH)

Dapp U1, Anders J1, Minder CE2, Golgert S1, Neumann L1, Pröfener F3, Wegscheider K4, Stender KP5, v Renteln-Kruse W1 1: Albertinen-Haus Hamburg, Forschungsabteilung, Zentrum für Geriatrie und Gerontologie, Wissenschaftliche Einrichtung an der Universität Hamburg, Sellhopsweg 18-22, D-22459 Hamburg 2: Horten-Zentrum, Universitäts-Spital Zürich, Rämistrasse 100, CH-8091 Zürich 3: Hamburgische Pflegegesellschaft, Burchardstraße 19, D-20095 Hamburg 4: Institut für Medizinische Biometrie und Epidemiologie (IMBE), Universität Hamburg, Martinistr. 52, D-20246 Hamburg 5: Behörde für Gesundheit und Verbraucherschutz (BGV) der Freien und Hansestadt Hamburg, Billstraße 80a, D-20539 Hamburg