Using the Hendrich II Inpatient Fall Risk Screen to Predict Outpatient Falls After Emergency Department Visits.

Area of Science:

• Geriatric Medicine
• Emergency Medicine
• Health Informatics

Background:

• Falls are a significant cause of emergency department (ED) visits for older adults.
• Predicting fall risk after ED discharge is crucial for preventing readmissions and improving patient outcomes.
• Routinely collected data in electronic health records (EHRs) offers potential for risk stratification.

Purpose of the Study:

• To evaluate the predictive utility of the Hendrich II fall risk score for 6-month ED revisits due to falls.
• To determine if the Hendrich II score performs better when used alone or in conjunction with other clinical variables.

Main Methods:

• Retrospective review of electronic health records for individuals aged 65 and older.
• Analysis of Hendrich II fall risk scores collected during index ED visits.
• Statistical modeling, including receiver operating characteristic (ROC) analysis, to assess predictive performance.

Main Results:

• The Hendrich II fall score alone had an area under the curve (AUC) of 0.64 for predicting fall-related ED revisits.
• Each 1-point increase in the Hendrich II score was associated with a 1.23-fold increased odds of a fall-related ED revisit.
• When combined with other predictors, the Hendrich II score significantly improved prediction (adjusted OR=1.15, AUC=0.75).

Conclusions:

• The Hendrich II fall score shows limited utility as a standalone predictor of fall-related ED revisits.
• Combining the Hendrich II score with easily extractable covariates enhances its predictive accuracy.
• Secondary use of EHR data, including fall scores, can identify high-risk individuals for targeted interventions without additional screening resources.