Validity of the Falls Risk for Older People in the Community (FROP-Com) tool to predict falls and fall injuries for older people presenting to the emergency department after falling

Abstract

The aims of this study were to (1) externally validate the accuracy of the Falls Risk for Older People-Community (FROP-Com) falls risk assessment tool in predicting falls, and (2) undertake initial validation of the accuracy of the FROP-Com to predict injurious falls (requiring medical attention) in people aged ≥60 years presenting to Emergency Departments (EDs) after falling. Two hundred and thirteen participants (mean age=72.4 years; 59.2% women) were recruited (control group of a randomised controlled trial). A FROP-Com assessment was completed at a home visit within two weeks of ED discharge. Data on falls and injurious falls requiring medical attention were collected via monthly falls calendars for the next 12-months. Predictive accuracy was evaluated using sensitivity and specificity of a high risk FROP-Com classification (score≥19) in predicting a fall, and injurious falls requiring medical attention. Fifty percent of participants fell, with 60.4% of falls requiring medical attention. Thirty-two percent were classified as high, 49% as moderate and 19% low falls risk. Low sensitivity was achieved for the FROP-Com high risk classification for predicting falls (43.4%) and injurious falls (34.4%), although specificity was high (79.4% and 78.6% respectively). Despite the FROP-Com's low predictive accuracy, the high fall rate and high falls risk of the sample suggest that older people who fall, present to ED and are discharged home are at high risk of future falls. In high falls risk populations such as in this study, the FROP-Com is not a valid tool for classifying risk of falls or injurious falls. Its potential value may instead be in identifying risk factors for falling to direct tailoring of falls prevention interventions to reduce future falls.

Characteristics of the Body Mass Frequency Index: a Novel Evaluation Index for Dysmotility Syndrome

“…FROP-Com is a fall risk assessment tool that can identify risk and contributing risk factors, with good reliability and modest fall prediction ability (32) . BMFI had some predictive effect on DS, and AUC area and specificity were higher than BMI, FRAX…”

Development of Nurse-Sensitive, Emergency Department–Specific Quality Indicators Using a Modified Delphi Technique

“…33 The identified QIs in the special populations (ie, geriatric, pediatric, obstetric, and psychiatric) category focused on the use of valid tools for identifying patients at risk for suicide (across all populations), abuse (across all special populations), and geriatric falls as well as documentation specifically of pregnancy status. The challenges of developing tools that are valid for use in emergency care settings are well documented for patients with suicidal ideation, [34][35][36][37] adult and geriatric falls, [38][39][40] intimate partner violence, and child and elder abuse. [41][42][43] Equally challenging is the lack of evidence to support their use, 44 suggesting that further research is necessary and calling into question the usefulness of screening as a current measure of quality.…”

Safe Walking Route Recommender Based on Fall Risk Calculation Using a Digital Human Model on a 3D Map

“…Intrinsic factors include the individual's mental and physical condition. Assessment models such as Home Assessment Profile (HAP) [20], cumulative risk score [21] and FROP-Com (Fall Risk for Older Adults in the Community) [22] were developed for risk calculation by considering the extrinsic factors. A fall risk assessment algorithm for the Japanese inpatient population was proposed recently by considering nine individual intrinsic factors that contribute to increased risk of falls [23].…”