跌倒风险评估量表在下肢动脉疾病住院患者中的应用比较研究

A comparative study on the application of the Fall Risk Assessment Scale(FRAS)for hospitalized patients with lower extremity arterial disease

目的探讨修订版Morse跌倒评估量表(Morse Fall Scale,MFS)、约翰霍普金斯跌倒风险评估量表(John Hopkins Fall Rish Assessment Tool,JHFRAT)以及住院患者跌倒风险评估量表(Fall Risk Assessment Scale,FRAS)评估下肢动脉疾病住院患者的临床应用研究。方法选取2019年5月-2020年1月首都医科大学附属北京朝阳医院血管外科下肢动脉疾病住院患者100例,由血管外科专科医师运用这三种量表对患者进行跌倒风险评估。采集结果数据进行配对logistics回归分析及ROC曲线分析,此外通过对数似然估计值分析三种量表间的预测价值差异,计算量表分布偏度系数。结果修订版MFS、JHFRAT以及住院患者FRAS三种评估量表均具有临床应用的评估价值。其中修订版MFS的AUC值最大,Kappa值最高,因此对下肢动脉疾病预测价值最高,显著优于住院患者FRAS和JHFRAT。结论三种评估量表均能预测下肢血管疾病住院患者的跌倒风险筛查,修订版MFS评估量表对于下肢动脉疾病住院患者预测效果最佳。

Objective To explore the application of the revised Morse Fall Scale(Morse Fall Scale),John Hopkins Fall Rish Assessment Tool(JHFRAT)and the Fall Risk Assessment Scale(FRAS)for hospitalized patients with lower extremity arteries diseases base on a comparative study of hospitalized patients.Methods A total of 100 hospitalized patients with lower extremity arterial disease in Department of Vascular Surgery from May 2019 to January 2020 were selected.The specialists in vascular surgery utilized these three scales to assess the fall risks.Through the collection of the result data,then paired logistics regression analysis,ROC curve analysis,and the log-likelihood method were used to estimate and compare the predicted value,calculate the scale distribution skewness coefficient.Results The revised Morse Fall Assessment Scale,Johns Hopkins Fall Risk Assessment Scale,and Inpatient Fall Risk Assessment Scale,all three assessment scales have evaluation value for fall risk in clinic.Among them,the revised Morse Fall Assessment Scale has the highest AUC value and Kappa value,so it has the highest predictive value for lower extremity arterial disease,which is significantly better than the Inpatient Fall Risk Assessment Scale and the Johns Hopkins Fall Risk Assessment Scale.Conclusion The three assessment scales can predict the fall risk of hospitalized patients with lower extremity vascular disease.The revised Morse Fall Assessment Scale has the best predictive effect for hospitalized patients with lower extremity arterial disease.