Características de la escala Downton en la valoración del riesgo de caídas en pacientes hospitalizados / Characteristics of the Downton fall risk assessment scale in hospitalised patients

Objetivo: Describir las características de las valoraciones del riesgo de caídas y el perfil de los pacientes que sufrieron caídas en un hospital público del Sistema Nacional de Salud y determinar si existió asociación entre la «presencia de caídas» y la puntuación previa en la escala Downton, con el objeto de calcular algunas de las características de esta herramienta: sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo, odss ratio y razón de verosimilitud. Metodología: diseño descriptivo retrospectivo sobre la incidencia de caídas registradas en el Complejo Hospitalario de Cartagena, realizando un análisis de las posibles causas y consecuencias de las mismas durante el período 2010-2015 (marzo). Un total de 576 pacientes sufrieron caídas durante el periodo analizado, de los cuales 107 no tenían ningún registro de «riesgo de caídas». La muestra final de pacientes fue de 469. El análisis estadístico de datos se realizó con el programa SPSSv.19. Resultados: En el contexto en el que se utiliza, la escala de Downton tiene una sensibilidad del 0,58; una especificidad de 0,62; una razón de verosimilitudes positiva del 1,55 y una razón de verosimilitudes negativa del 0,67. La odss ratio calculada fue de 2,31. Conclusiones: Los datos sobre incidencia de caídas (0,51%) son parecidos a los encontrados en otros trabajos. Los pobres resultados obtenidos en las características de la Escala Downton deberían ser una llamada de atención para las Instituciones Sanitarias. Una herramienta de valoración que clasifique a un paciente de riesgo debe ser incluida en los protocolos de seguridad del paciente si tiene una validez adecuada, y si permite evaluaciones rápidas y fiables que capten los cambios en la situación del paciente, con mejor criterio que el propio profesional de Enfermería (AU)

Objective: To describe the risk of falls assessments properties and profiles of the patients who fell in a public hospital of the National Health System, and to determine the relationship between the «presence of a fall» and the previous score using the Downton scale, in order to calculate some of the features of this tool: sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, and odss ratio. Materials and methods: a study with a descriptive retrospective design was conducted on the incidence of falls recorded in Cartagena Hospital. An analysis was made of possible causes and effects of falls during the period from March 2010 to March 2015. A total of 576 patients fell during the period of the study, of whom 107 were recorded in the no «fall risk» registry, leaving a sample of 469 patients in the study. Data analysis was performed using the SPSSv.19 Statistics Package. Results: In the context in which the assessment was made, the Downton scale had a sensitivity of 0.58, specificity 0.62, a positive likelihood ratio of 1.55, and negative likelihood ratio of 0.67. The odds ratio calculated was 2.31. Conclusions: The data on the incidence of falls (0.51%) are similar to those found in other studies. Poor scores obtained on the Downton Index should serve as a wakeup call for the healthcare institutions. An assessment tool that classifies the at-risk patient should be included in patient safety profiles, provided it is of relevant validity to cover any changes in the patient’s situation, and acts as a better yardstick than the nurses' own assessment (AU)

Characteristics of the Downton fall risk assessment scale in hospitalised patients. / Características de la escala Downton en la valoración del riesgo de caídas en pacientes hospitalizados.

OBJECTIVE: To describe the risk of falls assessments properties and profiles of the patients who fell in a public hospital of the National Health System, and to determine the relationship between the "presence of a fall" and the previous score using the Downton scale, in order to calculate some of the features of this tool: Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, and odss ratio. MATERIALS AND METHODS: A study with a descriptive retrospective design was conducted on the incidence of falls recorded in Cartagena Hospital. An analysis was made of possible causes and effects of falls during the period from March 2010 to March 2015. A total of 576 patients fell during the period of the study, of whom 107 were recorded in the no "fall risk" registry, leaving a sample of 469 patients in the study. Data analysis was performed using the SPSSv.19 Statistics Package. RESULTS: In the context in which the assessment was made, the Downton scale had a sensitivity of 0.58, specificity 0.62, a positive likelihood ratio of 1.55, and negative likelihood ratio of 0.67. The odds ratio calculated was 2.31. CONCLUSIONS: The data on the incidence of falls (0.51%) are similar to those found in other studies. Poor scores obtained on the Downton Index should serve as a wakeup call for the healthcare institutions. An assessment tool that classifies the at-risk patient should be included in patient safety profiles, provided it is of relevant validity to cover any changes in the patient's situation, and acts as a better yardstick than the nurses' own assessment.