Casa Colina Fall Risk Assessment Scale-Revised: Predicting Falls in Inpatient Rehabilitation Facilities.

Area of Science:

• Gerontology and Rehabilitation Medicine
• Patient Safety and Fall Prevention

Background:

• Fall risk assessment is crucial in inpatient rehabilitation facilities (IRFs) for patient safety.
• Existing tools may not fully align with current quality measures, necessitating an update.

Purpose of the Study:

• To revise the Casa Colina Fall risk assessment scale (CCFRAS) using new Medicare functional ability quality measures.
• To evaluate the sensitivity and specificity of the revised scale (CCFRAS-R) in predicting fall risk.

Main Methods:

• The CCFRAS-R was assessed retrospectively and prospectively in 3 IRFs.
• Data from 6253 adult patients undergoing medical rehabilitation were analyzed.
• Logistic regression identified significant fall predictors; area under the curve determined cut-off scores.

Main Results:

• Impaired toileting hygiene, transfers, and difficulty walking were significant fall predictors.
• The CCFRAS-R demonstrated a sensitivity of 0.6 and specificity of 0.62 in validation (P=.001).
• The revised scale showed good agreement (0.72) with the original CCFRAS.

Conclusions:

• The revised Casa Colina Fall risk assessment scale (CCFRAS-R) is effective for predicting fall risk in IRFs.
• The CCFRAS-R is broadly generalizable, though sensitivity and specificity may vary with patient acuity and environment.