Get access

Discriminating High Fall Risk on an Inpatient Rehabilitation Unit

Authors

  • Michael J. Gilewski PhD,

    Assistant Professor, Corresponding authorSearch for more papers by this author
    • Michael J. Gilewski, PhD, is assistant professor of physical medicine at Loma Linda University.

  • Pamela Roberts PhD OTR/L,

    Manager of Rehabilitation, Psychology and NeurologySearch for more papers by this author
    • Pamela Roberts, MSHA OTR/L, is a manager of rehabilitation, psychology and neurology at the Department of Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA.

  • Jodi Hirata MPT,

    Physical TherapistSearch for more papers by this author
    • Jodi Hirata, MPT, is a physical therapist at the Department of Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA.

  • Richard Riggs MD

    Medical DirectorSearch for more papers by this author
    • Richard Riggs, MD, is a medical director of the Department of Rehabilitation and chairman of the Department of Physical Medicine at Cedars-Sinai Medical Center, Los Angeles, CA.


11406 Loma Linda Drive, Loma Linda, CA 92354-3711 or mgilewski@llu.edu.

Abstract

The objective of this study was to identify on admission the most discriminating fall predictors for patients to an inpatient rehabilitation unit. Medical information from 34 patients who fell over a consecutive 7-month period and 102 controls (1:3 ratio) matched for diagnosis, age, and gender was analyzed to identify a set of best predictors. Admission mobility and problem solving FIM™ scores accounted for 17% of variance in whether a fall occurred during the admission. After statistically deriving optimal cutoff thresholds for decision making, high fall risk was retroactively assigned to patients. Logistic regression revealed increased odds of having fallen by 5.1 times for poorer mobility and 2.4 times for poorer problem solving. The practical benefits of the evidence-based risk assessment were discussed.

Ancillary