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The following is a summary of “Quality evaluation of the usefulness of an emergency department fall risk assessment tool,” published in the February 2024 issue of Emergency Medicine by Ortenzio, et al.

Falls within hospital settings pose significant challenges in prediction and prevention, potentially leading to adverse patient outcomes. While various fall predictor tools exist, they are predominantly studied within in-patient units, raising questions about their applicability in the unique environment of the emergency department (ED). The Memorial Emergency Department Fall Risk Assessment Tool (MEDFRAT) has effectively predicted fall risk in the ED setting. For an IRB-approved study, researchers sought to evaluate the predictive validity of the MEDFRAT in an ED at a level 1 trauma center.

A retrospective cohort analysis was conducted using electronic medical records of patients meeting inclusion criteria at the level 1 trauma center ED. Data included MEDFRAT components, demographics, and Moving Safely Risk Assessment (MSRA) Tool results. Receiver operating characteristic (ROC) curves were constructed to determine optimal cutoffs for fall risk prediction. Sensitivity, specificity, accuracy, and likelihood ratios were calculated for identified cutoff values. The tool performance was compared using the area under the ROC curves.

MEDFRAT exhibited significantly higher sensitivity than MSRA (83.1% vs. 66.1%, P = 0.002), while MSRA showed higher specificity (84.5% vs. 69.0%, P = 0.012). ROC analysis identified a MEDFRAT score of ≥1 as the optimal cutoff for identifying any fall risk. The area under the curve was higher for MEDFRAT than MSRA (0.817 vs. 0.737).

The study validated the MEDFRAT as an effective tool for predicting in-hospital falls in a level 1 trauma center ED. Accurately identifying high-risk patients is essential for improving patient safety and health outcomes while reducing healthcare costs.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723005740