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Falls risk following discharge from a geriatric day hospital

Royal Infirmary, Glasgow; Department of Medicine for the Elderly, Gartnavel General Hospital, Glasgow, Scotland, UK

Brendan J Martin

Royal Infirmary, Glasgow; Department of Medicine for the Elderly, Hairmyres Hospital, East Kilbride, Scotland, UK

Sarah L Mitchell

Department of Physiotherapy, Royal Infirmary, Glasgow, Scotland, UK

Tom C Aitchison

Department of Statistics, Glasgow University, Glasgow, Scotland, UK

Objective: To assess the predictive validity of the Elderly Mobility Scale (EMS), Functional Reach (FR) and the Barthel Index (BI) in identifying recurrent fallers following discharge from a geriatric day hospital (GDH).

Subjects: Seventy-six GDH patients with identified mobility problems.

Methods: Each patient was assessed by an independent physiotherapist before and after a programme of physiotherapy using the EMS, FR and BI and a ‘falls follow-up’ assessment was performed after four months.

Results: Fifty-four per cent (29 out of 54) of patients had reduced mobility at follow-up. Twenty-five per cent (18 out of 71) of patients had two or more falls post discharge. Using logistic regression analysis for EMS, FR and BI at discharge, each of these variables individually was significantly associated with the risk of having two or more falls (p = 0.008, 0.017 and 0.031 respectively). A prognostic tree was developed for GDH patients identifying high-risk and low-risk groups.

Conclusion: EMS, FR and BI were all significantly associated with GDH patients with mobility problems having two or more falls. A prognostic tree identified high and low-risk groups of GDH patients and should now be tested prospectively. Introduction

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