3种跌倒风险评估工具对养老机构中老年人跌倒风险的预测价值比较

Comparison of predictive value of three fall risk assessment tools among middle⁃aged and elderly people in nursing facilities

目的:探讨Morse跌倒评估量表(MFS)、托马斯跌倒风险评估工具(STRATIFY量表)、简易体能状况量表(SPPB)3种跌倒风险评估工具对养老机构中老年人跌倒风险的预测价值。方法:整群随机抽取湖南省4个地州市共80所养老机构内的4041名中老年人,采用一般资料调查表、MFS、STRATIFY、SPPB量表进行资料收集。使用受试者工作特征(ROC)曲线评估不同评估量表对跌倒的预测效果。结果:共调查4041名老年人,676人(16.73%)1年内发生跌倒。跌倒组和未跌倒组年龄、性别、是否合并慢性病、是否抑郁比较差异有统计学意义(P<0.05)。MFS的ROC曲线下面积(AUC)为0.850[95%CI(0.834,0.867)],当总分为37.5分时,约登指数为0.597,量表的预测价值最大;STRATIFY量表AUC为0.764[95%CI(0.744,0.783)],当总分为1.5分时,约登指数为0.407,量表的预测价值最大;SPPB的AUC为0.675[95%CI(0.654,0.697)],当总分为7.5分时,约登指数为0.293,量表的预测价值最大。MFS的AUC、约登指数均高于其他2个量表。结论:MFS、STRATIFY、SPPB量表对养老机构中老年人跌倒风险均有预测价值,MFS的预测价值高于STRATIFY、SPPB量表。

Objective:To compare and explore the predictive value of three fall risk assessment tools,which were Morse Fall Assessment Scale(MFS),St Thomas′s Risk Assessment Tool(STRATIFY Scale),and Short Physical Performance Battery(SPPB)in middle⁃aged and elderly people in nursing facilities.Methods:4041 cases of middle⁃aged and elderly people were randomly selected from a total of 80 nursing homes in 4 cities and prefectures in Hunan province using the General Information Questionnaire,MFS,STRATIFY Scale,and SPPB Scale.The ROC curves were used to assess the predictive effect of different fall assessment scales on falls.Results:A total of 4041 cases of middle⁃aged and elderly people in nursing institutions were investigated,and 676 people(16.73%)had fallen within one year.The results showed that there were statistically significant differences between the fall group and the no⁃fall group in comparing middle⁃aged and elderly people in age,gender,whether they had comorbid chronic diseases,and whether they were depressed(P<0.05).The AUC of the MFS was 0.850(95%CI 0.834⁃0.867),and the Jorden index was 0.597 when the total score was 37.5,and the scale had the greatest predictive value;the AUC of the STRATIFY was 0.764(95%CI 0.744⁃0.783),when the total score was 1.5,and the Jorden index was 0.407,and the scale had the greatest predictive value;the AUC of the SPPB was 0.675(95%CI 0.654⁃0.697),when the total score was 7.5,and the Jorden index was 0.293,and the scale had the greatest predictive value.The AUC of the MFS scale and the Jorden index were higher than the other two scales.Conclusion:MFS,STRATIFY,and SPPB all have predictive value for the fall risk of the elderly in nursing facilities,and the predictive value of MFS is higher than STRATIFY and SPPB.