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Validation and Improvement of the Saga Fall Risk Model: A Multicenter Retrospective Observational Study.
Tago, Masaki; Hirata, Risa; Katsuki, Naoko E; Nakatani, Eiji; Tokushima, Midori; Nishi, Tomoyo; Shimada, Hitomi; Yaita, Shizuka; Saito, Chihiro; Amari, Kaori; Kurogi, Kazuya; Oda, Yoshimasa; Shikino, Kiyoshi; Ono, Maiko; Yoshimura, Mariko; Yamashita, Shun; Tokushima, Yoshinori; Aihara, Hidetoshi; Fujiwara, Motoshi; Yamashita, Shu-Ichi.
Afiliación
  • Tago M; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Hirata R; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Katsuki NE; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Nakatani E; Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
  • Tokushima M; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Nishi T; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Shimada H; Shimada Hospital of Medical Corporation Chouseikai, Saga, Japan.
  • Yaita S; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Saito C; Shizuoka General Hospital, Shizuoka, Japan.
  • Amari K; Department of Emergency Medicine, Saga-Ken Medical Centre Koseikan, Saga, Japan.
  • Kurogi K; Department of General Medicine, National Hospital Organization Ureshino Medical Center, Saga, Japan.
  • Oda Y; Department of General Medicine, Yuai-Kai Foundation and Oda Hospital, Saga, Japan.
  • Shikino K; Department of General Medicine, Chiba University Hospital, Chiba, Japan.
  • Ono M; Department of Community-Oriented Medical Education, Chiba University Graduate School of Medicine, Chiba, Japan.
  • Yoshimura M; Department of General Medicine, Karatsu Municipal Hospital, Saga, Japan.
  • Yamashita S; Safety Management Section, Saga University Hospital, Saga, Japan.
  • Tokushima Y; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Aihara H; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Fujiwara M; Department of General Medicine, Saga University Hospital, Saga, Japan.
  • Yamashita SI; Department of General Medicine, Saga University Hospital, Saga, Japan.
Clin Interv Aging ; 19: 175-188, 2024.
Article en En | MEDLINE | ID: mdl-38348445
ABSTRACT

Purpose:

We conducted a pilot study in an acute care hospital and developed the Saga Fall Risk Model 2 (SFRM2), a fall prediction model comprising eight items Bedriddenness rank, age, sex, emergency admission, admission to the neurosurgery department, history of falls, independence of eating, and use of hypnotics. The external validation results from the two hospitals showed that the area under the curve (AUC) of SFRM2 may be lower in other facilities. This study aimed to validate the accuracy of SFRM2 using data from eight hospitals, including chronic care hospitals, and adjust the coefficients to improve the accuracy of SFRM2 and validate it. Patients and

Methods:

This study included all patients aged ≥20 years admitted to eight hospitals, including chronic care, acute care, and tertiary hospitals, from April 1, 2018, to March 31, 2021. In-hospital falls were used as the outcome, and the AUC and shrinkage coefficient of SFRM2 were calculated. Additionally, SFRM2.1, which was modified from the coefficients of SFRM2 using logistic regression with the eight items comprising SFRM2, was developed using two-thirds of the data randomly selected from the entire population, and its accuracy was validated using the remaining one-third portion of the data.

Results:

Of the 124,521 inpatients analyzed, 2,986 (2.4%) experienced falls during hospitalization. The median age of all inpatients was 71 years, and 53.2% were men. The AUC of SFRM2 was 0.687 (95% confidence interval [CI]0.678-0.697), and the shrinkage coefficient was 0.996. SFRM2.1 was created using 81,790 patients, and its accuracy was validated using the remaining 42,731 patients. The AUC of SFRM2.1 was 0.745 (95% CI 0.731-0.758).

Conclusion:

SFRM2 showed good accuracy in predicting falls even on validating in diverse populations with significantly different backgrounds. Furthermore, the accuracy can be improved by adjusting the coefficients while keeping the model's parameters fixed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hospitalización / Hospitales Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Clin Interv Aging Asunto de la revista: GERIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Nueva Zelanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hospitalización / Hospitales Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Clin Interv Aging Asunto de la revista: GERIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Nueva Zelanda