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Aging Clin Exp Res. 2016 Feb;28(1):139-46. doi: 10.1007/s40520-015-0378-4. Epub 2015 May 30.

Post-hoc validation of the Conley Scale in predicting the risk of falling with older in-hospital medical patients: findings from a multicentre longitudinal study.

Author information

1
Udine University, Viale Ungheria 20, 33100, Udine, Italy. alvisa.palese@uniud.it.
2
Verona University, Verona, Italy.
3
Udine University, Viale Ungheria 20, 33100, Udine, Italy.
4
Azienda per i Servizi Sanitari Provincia, Trento, Italy.
5
Azienda Ospedaliera Verona, Verona, Italy.
6
Fondazione Poliambulanza, Brescia, Italy.
7
Azienda Unità Sanitaria Locale n. 9 Treviso, Treviso, Italy.
8
Azienda per i Servizi Sanitari n. 2 "Isontina", Gorizia, Italy.
9
Azienda Unità Sanitaria Locale n. 6 Vicenza, Vicenza, Italy.
10
Azienda per i Servizi Sanitari n. 4 "Medio Friuli", Udine, Italy.
11
Azienda Ospedaliera S.Orsola-Malpighi, Bologna, Italy.
12
Fondazione Zancan, Padua, Italy.
13
Bologna University, Bologna, Italy.
14
Azienda Ospedaliero-Universitaria, Padua, Italy.

Abstract

BACKGROUND:

The Conley Scale is one of the most widespread fall-risk screening tools in medical unit settings, despite the lack of data regarding its validity in patients currently admitted to these units.

AIMS:

Establishing the validity of the Conley Scale in identifying patients at risk of falling in an acute medical setting.

METHODS:

A 6-months longitudinal study in 12 acute medical units from September 2012 to March 2013, a total of 1464 patients with ≥65 years of age were consecutively enrolled and evaluated with the Conley Scale within 24 h of admission. A construct validity, internal consistency, and a priori and a posteriori predictive validity study was performed.

RESULTS:

The explorative factor analysis showed a two-factor structure explaining a total variance of 48.3 %: previous history (30.41 %), and physical and cognitive impairment (17.9 %). The scale reported a poor internal consistency (Cronbach's α = 0.465) and the capability to correctly identify 18/649 patients as being at risk of falling, whereas the negative predictive value was 98.5 %. The sensitivity and specificity values were 60.0 and 55.9 %, respectively. No difference emerged between patients scored as at risk and those scored as not at risk in the time elapsed from admission to the first fall (HR = 0.600, 95 % CI 0.289-2.247 p = .166).

DISCUSSION:

The Conley Scale is not able to predict falls in elderly acute medical patients, and has reported poor internal consistency and accuracy.

CONCLUSIONS:

More studies are needed to develop appropriate tools to predict the risk of falling in elderly individuals admitted to an acute medical setting.

KEYWORDS:

Accidental falls; Acute medical inpatients; Conley Scale; Fall-risk assessment tools; Sensitivity; Specificity; Validation

PMID:
26025462
DOI:
10.1007/s40520-015-0378-4
[Indexed for MEDLINE]

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