Humpty Dumpty儿童跌落风险评估量表敏感度和特异度的评价

The analysis of sensitivity and specificity of Humpty Dumpty pediatric fall assessment tool for hospitalized children

目的研究Humpty Dumpty儿童跌落风险量表(HDFS)的敏感度和特异度,探索该量表的最佳临界值,以便更好地识别跌落高风险患儿。方法采用回顾性病例配对对照研究设计,根据年龄、性别、诊断三大因素按照1∶1配对,对52例跌落病例和52例未跌落病例进行病史回顾,运用HDFS进行各条目的评估。结果HDFS的最佳预测工作点是16分,此时灵敏度为0.558,特异度为0.635,ROC曲线下面积为0.610。经比较,当工作点为≥13分时,跌落组和对照组得分分别为(15.77±1.46)、(15.22±1.21)分,2组得分比较差异有统计学意义(t=3.98,P<0.05)。结论HDFS具有部分识别跌落高风险患儿的能力,最佳理论工作点为16分,推荐最佳工作点为13分。HDFS的使用能为高风险跌落患儿护理干预提供一定参考依据。HDFS的理论诊断价值处于较低水平,需要更进一步的研究来验证或改善评估工具。

Objective To determine the sensitivity and specificity of the Humpty Dumpty Fall Scale(HDFS)in predicting the falls in hospitalized children.Methods A retrospective matched case-control study was conducted.A chart review of 52 pediatric cases who fell and 52 controls who did not fall,were pair-matched by age,gender and diagnosis and matching ratio of 1∶1.The HDFS was used to evaluate the risk factors.Results The area of the ROC curve was 0.610.When the cutoff point of HDFS was 16,the sensitivity of it was 0.558,and the specificity was 0.635.There was a significant difference in two groups when the cutoff point was 13(P<0.05),the score in fall case and non-fall case was(15.77±1.46),(15.22±1.21)points.Conclusions The HDFS can identify high risk of falls in hospitalized children in some degree.The optimal operating point is 13.The theoretical diagnostic value of the scale is at a low level.Further research is needed to verify or to improve the assessment tool that contribute to fall reduction.