美国CDC社区老人跌倒风险自评量表与Morse跌倒评估量表在中国住院老年患者中的应用比较

Comparison of the application of United States CDC self-rated fall risk questionnaire and Morse fall scale in hospitalized elderly patients in China

目的 通过与中文版Morse跌倒评估量表(CMFS)对比,评估美国疾病预防与控制中心公布的社区老人跌倒风险自评量表(FRQ)在中国住院老年患者跌倒风险评估中的适用性。方法 本研究为横断面研究,采用便利抽样法,选取2023年1月至6月湖南省长沙市某三甲医院符合纳入及排除标准的420例住院老年患者为研究对象,收集患者一般资料、中文版FRQ(CFRQ)和CMFS评分及初次调查后90 d内的跌倒发生情况,分析受试者操作特征曲线、灵敏度、特异度、最佳临界值。结果 以“过去1年是否跌倒”为状态变量时,CFRQ和CMFS评分的受试者操作特征曲线下面积(AUC)值分别为0.829和0.767,当CFRQ和CMFS的最佳临界值分别为4.5分和47.5分时,约登指数分别为0.506和0.467,灵敏度分别为81.8%和51.9%,特异度分别为68.8%和94.8%。以“初次调查后90 d内的跌倒发生情况”为状态变量时,最佳临界值下的分组为检验变量时,CFRQ分组和CMFS分的AUC值分别为0.678和0.643,灵敏度分别为75.0%和41.7%,特异度分别为60.5%和87.0%。结论 与CMFS比较,CFRQ的诊断价值、真实性、灵敏度更好。

Objective To evaluate the applicability of the self-rated fall risk questionnaire(FRQ) in community-dwelling published by the United States Centers for Disease Control and Prevention in the assessment of fall risk in elderly inpatients in China through compared it with the Chinese version of the Morse fall scale(CMFS).Methods This study was a cross-sectional study using convenience sampling method.A total of 420 elderly inpatients who met the inclusion criteria in a tertiary hospital in Changsha,Hunan Province from January to June 2023 were selected as the study subjects.General patient information,Chinese version of FRQ(CFRQ) and CMFS scores,and the incidence of falls within 90 days after the initial survey were collected,and the receiver operating characteristic(ROC) curve,sensitivity,specificity,and the optimal critical value were analyzed.Results When“whether falls occurred in the past year”was used as the state variable,the area under the curve(AUC) values of CFRQ and CMFS were 0.829 and 0.767,respectively.When the optimal critical values of CFRQ and CMFS were 4.5 and 47.5 points,respectively,the Youden index were 0.506 and 0.467,with sensitivity of 81.8%and 51.9%,and specificity of 68.8% and 94.8%,respectively.When using the “occurrence of falls within 90 days after the initial investigation”as the state variable and the grouping under the optimal critical value as the test variable,the AUC values of the CFRQ group and the CMFS group were 0.678 and 0.643,respectively,with sensitivity of 75.0% and 41.7%,and specificity of 60.5% and 87.0%.Conclusion Compared with CMFS,CFRQ has better diagnostic value,authenticity,and sensitivity.