박성희1, 김은경2

1순천향대학교 간호학과, 2충북대학교 간호학과

Background: The aim of this study was to determine which fall-risk tool is most accurate for detecting and predicting
adults in the hospital setting.
Methods: A literature search was performed to identify all studies published between 1946 and 2014 from periodicals
indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases, using the following
keywords: ‘fall’, 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The
QUADAS-2 was applied to assess the internal validity of the diagnostic studies. Fourteen studies were analyzed
using meta-analysis with MetaDisc 1.4.
Results: The result of comparing twelve tools was that the Morse Fall Scale (MFS) is the best tool for predicting
falls for acute hospitalized adult patients. Six prospective validation studies using MFS with high methodological
quality, involving 9,255 patients, were included. Meta-analysis finding of MFS was as follows; pooled
sensitivity 0.73 (95% confidence interval [CI]: 0.68-0.78), pooled specificity 0.75 (95% CI: 0.74-0.76), area under
the curve (AUC) of summary receiver operating characteristics (sROC) curve 0.79 (standard error [SE] =
0.02), and value of index Q* 0.72 (SE = 0.01) respectively.
Conclusions: Falls in hospitalized adult patients can be effectively prevented using the MFS. These findings
provide scientific evidence for using appropriate tool to prevent accidental falls and improve the safety of
patients.
Korean J Health Promot 2016;16(3):180-191
Keywords: Accidental falls, Sensitivity and specificity, Meta-analysis