Systematic Review and Meta-analysis for Usefulness of Fall Risk Assessment Tools in Adult Inpatients

ABSTRACT

BACKGROUND: The aim of this study was to determine which fall-risk tool is most accurate for detecting and predicting adults in the hospital setting. METHODS: A literature search was performed to identify all studies published between 1946 and 2014 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-2 was applied to assess the internal validity of the diagnostic studies. Fourteen studies were analyzed using meta-analysis with MetaDisc 1.4. RESULTS: The result of comparing twelve tools was that the Morse Fall Scale (MFS) is the best tool for predicting falls for acute hospitalized adult patients. Six prospective validation studies using MFS with high methodological quality, involving 9,255 patients, were included. Meta-analysis finding of MFS was as follows; pooled sensitivity 0.73 (95% confidence interval [CI]: 0.68-0.78), pooled specificity 0.75 (95% CI: 0.74-0.76), area under the curve (AUC) of summary receiver operating characteristics (sROC) curve 0.79 (standard error [SE] = 0.02), and value of index Q* 0.72 (SE = 0.01) respectively. CONCLUSIONS: Falls in hospitalized adult patients can be effectively prevented using the MFS. These findings provide scientific evidence for using appropriate tool to prevent accidental falls and improve the safety of patients.