Morse跌倒评估量表与Berg平衡量表应用于老年患者预测跌倒风险的效果分析

摘要

Objective: To investigate the effectiveness of Morse fall scale(MFS) and Berg balance scale (BBS) in the fall risk prediction for senile patients.Method: MFS and BBS were respectively used by two trained nurses to predict the fall risk of 161 senile patients from 3 Grade A hospitals in Guangzhou. Then 3 months later the patients were followed up by phone to know whether fall occurred in this recent 3 months. The sensitivity, specificity and area under the receiver operating characteristic(ROC) curve (AUC) were analyzed for each tool.Result: The AUC value of MFS was 0.893 (P<0.01). With the cutoff value as 25, the sensitivity and specificity of MFS were 100% and 11% respectively. When the cutoff value was 45, the sensitivity and specificity of MFS were 96% and 36%. If the cutoff value equaled 50, the sensitivity and specificity of MFS were 96% and 52%. With the cutoff value as 55, the sensitivity and specificity of MFS were 92% and 64%. The AUC value of BBS was 0.654 (P<0.05). With the cutoff value as 45, the sensitivity and specificity of BBS were 72% and 40% respectively. When the cutoff value was 40, the sensitivity and specificity of MFS were 68% and 57%. Conclusion: Both MFS and BBS showed high effectiveness in fall risk prediction for senile patients. The recommended cutoff value of MFS was 55, and 40 for BBS. The prediction effect of MFS was better than that of BBS. According to the characteristic of senile patients proper scale should be used by clinical nurses in clinics.%目的:测量并比较Morse跌倒评估量表(MFS)及Berg平衡量表(BBS)应用于老年患者的跌倒风险预测效果.方法:两名测试护士使用MFS及BBS分别对161例老年患者进行跌倒风险评估,3个月后电话随访患者是否在此期间跌倒.分析量表不同诊断界值的敏感度、特异度及接受者操作特性(ROC)曲线.结果:MFS的ROC曲线下面积(AUC)为0.893 (P＜ 0.01),其敏感度和特异度在诊断界值为25分时分别为100％和11％,在45分时分别为96％和36％,在50分时分别为96％和52％,在55分时相对平衡,分别为92％和64％.BBS的AUC为0.654(P＜0.05),其敏感度和特异度在诊断界值为45分时分别为72％和40％,在40分时相对平衡,分别为68％和57％.结论:两种量表应用于我国老年患者的预测效果均较好,推荐MFS的诊断界值为55分,BBS诊断界值为40分.MFS较BBS的预测效果好,临床需结合患者的特点选择合适的量表并由临床护士使用.