Stürze in der neurologischen Rehabilitation: Entwicklung der Hessisch Oldendorfer Sturzrisiko-Skala (HOSS)

Zusammenfassung

Ziel der Studie: Stürze stellen während der neurologischen Rehabilitation ein erhebliches Risiko dar. Die Identifizierung sturzgefährdeter Rehabilitanden ist mittels bestehender Sturzrisiko-Skalen nur in einem unzureichenden Maß möglich. Daher war es Ziel dieser Studie eine Risiko-Skala für neurologische Rehabilitanden zu entwickeln.

Methodik: Auf Grundlage von Sturz-Ereignisprotokollen wurden Charakteristika von 444 gestürzten neurologischen Rehabilitanden identifiziert und für die Entwicklung der Hessisch Oldendorfer Sturzrisiko-Skala (HOSS) verwendet. Die Häufigkeit eines Sturzereignisses wurde anschließend mit dem ermittelten HOSS- sowie Huhn Score der Sturzrisiko-Skala nach Huhn korreliert.

Ergebnisse: Die Faktore im Internet Alter, Geschlecht, Tag nach Aufnahme, Barthel-Index, Inkontinenz, Hilfsmittel, Medikamente und neurologische Erkrankungen konnten als sturzassoziierte Faktoren identifiziert und zur Entwicklung der HOSS herangezogen werden. Der ermittelte HOSS Score korrelierte signifikant mit der Sturzanzahl der Rehabilitanden (p=0,014).

Schlussfolgerung: Die HOSS kann die Sturzanzahl besser prognostizieren als die Sturzrisiko-Skala nach Huhn. Multizentrische Studien und Untersuchungen mit höheren Fallzahlen werden empfohlen, um die Validität der HOSS weiter zu fundieren. Abstract in Main Document.

Abstract

Objective: Falls are a relevant problem in neurological rehabilitation. Identification of patients with a high risk to fall with existing risk assessment tools is not satisfactory. Therefore this study aims to develop an adjusted assessment tool for neurological patients.

Methods: Conditions of falls from 444 neurological patients were analyzed to develop the Hessisch Oldendorf fall risk scale (HOSS). Afterwards, the number of falls was correlated with HOSS score as well as by the standardized used fall risk scale by Huhn.

Results: The parameters age, sex, days of stay, barthel-index, incontinence, aids, drugs and neurological diseases were identified as potential fall associated factors and were used to generate the HOSS. The HOSS score was significantly associated with the number of falls of neurological patients during rehabilitation (p=0.014).

Conclusions: The number of multiple falls for neurological patients is better assessed by the HOSS than by fall risk scale by Huhn. Nevertheless, studies with a higher number of patients as well as studies with a multicentre design should be performed to underpin the validity of the HOSS.

Schlüsselwörter

Stürze - Risikobewertung - neurologische Rehabilitation - Barthel-Index

Keywords

falls - risk assessment - neurological rehabilitation - barthel index

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