改良版托马斯跌倒风险评估量表与Morse跌倒评估量表对老年住院病人跌倒的预测价值  

Predictive value of modified Thomas fall risk assessment scale and Morse falling scale for falling risk in the elderly inpatients

作　　者：嵇加佳[1] 戴曦[2] 梅克文[2] JI Jia-jia;DAI Xi;MEI Ke-wen(Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一附属医院内分泌科,江苏省南京市210029 [2]南京医科大学第一附属医院老年医学科,江苏省南京市210029

出　　处：《实用老年医学》2019年第6期611-613,共3页Practical Geriatrics

摘　　要：目的 探讨医院自制的改良版托马斯跌倒风险评估量表和Morse跌倒评估量表(MFS)对老年住院病人跌倒风险评估的预测价值。 方法 对1849例老年住院病人分别采用医院自制改良版托马斯跌倒风险评估量表和MFS进行评分,绘制两量表受试者工作特性曲线(ROC)并计算曲线下面积(AUC),计算2个量表的灵敏度、特异度及正确诊断指数来评价量表的效力。 结果 跌倒病人的2个跌倒风险评估量表得分均显著高于非跌倒病人,差异有统计学意义(P<0.01)。改良版托马斯跌倒风险评估量表的灵敏度和特异度分别为100%、54.3%,阳性预测值为2.567%,阴性预测值为100%,AUC为0.808;MFS的灵敏度和特异度分别为86.4%、70.8%,阳性预测值为3.443%,阴性预测值为99.8%,AUC为0.842。2种量表对老年住院病人跌倒均有筛检价值(P<0.01),但两量表间差异无统计学意义(P>0.05)。MFS的正确诊断指数(0.572)高于改良版托马斯跌倒风险评估量表(0.543)。 结论 2种量表对老年病人跌倒事件均具有预测价值,其中MFS对老年住院病人跌倒的筛检能力较高,改良版托马斯跌倒风险评估量表灵敏度高,预测能力较强。Objective To explore the predictive value of the modified Thomas fall risk assessment scale and Morse falling scale (MFS) for falling risk assessment of the elderly inpatients. Methods A total of 1849 hospitalized elderly patients underwent the assessment of hospital-made modified Thomas fall risk assessment scales and MFS. The receiver operating characteristic curve (ROC) of two scales was drawn and the area under the curve (AUC)was calculated. The sensitivity, specificity, correct diagnosis index, and AUC were calculated to evaluate the efficacy of two scales. Results The scores of falling patients evaluated by the two fall risk assessment scales were significantly higher than those of non-falling patients(P<0. 01). The sensitivity and specificity of the modified Thomas fall risk assessment scale was 100% and 54. 3% respectively, and the positive predictive value was 2. 567%, the negative predictive value was 100%, and AUC was 0. 808. The sensitivity and specificity of MFS was 86. 4% and 70. 8% respectively, and the positive predictive value was 3.443%, negative predictive value was 99.8%, and AUC was 0. 842. Both scales had a screening value for falls in the elderly inpatients (P<0. 01), but there was no significant difference between the two scales (P>0. 05). The correct diagnostic index of MFS (0. 572) was higher than that of the modified Thomas fall risk assessment scale (0. 543). Conclusions Both scales have predictive value for falling events in the elderly inpatients. MFS has high screening capacity for the elderly inpatients with falls, and the modified Thomas fall risk assessment scale has high sensitivity and strong predictive power.

关 键 词：老年人 跌倒 危险评估 Morse跌倒评估量表 

分 类 号：R473[医药卫生—护理学]