Validation of the stratify scale for the prediction of falls among hospitalized adults in a tertiary hospital in Colombia: a retrospective cohort study

Abstract

The STRATIFY scale has been implemented as a preventive strategy for predicting the risk of accidental falls among hospitalized adults. However, there is still uncertainty about its accuracy. This study aimed to perform an external validation of the STRATIFY fall prediction scale in hospitalized adults in one tertiary care hospital in Bogotá, Colombia. The study was a retrospective cohort of adult hospitalized patients in a high-level complexity care hospital. The sample selected included admitted patients (age ≥ 18), consecutively by the institution between 2018 and 2020, with an evaluation of the fall risk measured by the STRATIFY score given to each at the time of hospital admission. For assessing the scale's feasibility, its discriminative capability was obtained by calculating sensitivity, specificity, likelihood ratios, predictive values, and area under the ROC curve. The evaluation included 93,347 patient hospital records (mean 56.9 years, 50.2% women). The overall sensitivity score was 0.672 [IC 95% 0.612–0.723], the specificity score was 0.612 [IC 95% 0.605–0.615], and the positive likelihood ratio was 1.73 [IC 95% 1.589–1.891]. The area under the ROC curve was 0.69 [IC 95% 0.66–0.72]. Subgroups of age obtained similar results. Applying the STRATIFY scale at hospital admission resulted in a lower performance of the tool–predict falls in hospitalized patients. It is necessary to implement an individual evaluation of the risk factors for falls in order to structure appropriate care plans to prevent and improve hospital safety.