Schmidt et al reported the Hessisch Oldendorf Risk of Falling Scale (HOSS) for evaluating the risk of falling for a neurological rehabilitation patient. The authors are from Hanover Medical School and BDH-Clinic Hessisch Oldendorf in Hessisch Oldendorf, Germany.
Patient selection: neurological rehabilitation patient
Parameters:
(1) gender
(2) time since admission in days
(3) age in years
(4) Barthel Index, from 0 to 100
(5) walking of walking aid
(6) feeling of security with walking aid
(7) hemiparesis
(8) disorder of orientation
(9) daily use of anticonvulsants
(10) daily use of laxatives
(11) urinary incontinence
(12) somnolent state
|
Parameter |
Finding |
Points |
|
gender |
male |
1 |
|
|
female |
0 |
|
time since admission |
< 15 days |
2 |
|
|
15 to 28 days |
1 |
|
|
> 28 days |
0 |
|
age in years |
< 40 |
0 |
|
|
40 to 60 |
1 |
|
|
60 to 80 |
3 |
|
|
> 80 |
0 |
|
Barthel index |
0 to 15 |
4 |
|
|
20 to 30 |
3 |
|
|
35 to 50 |
2 |
|
|
55 to 70 |
1 |
|
|
> 70 |
0 |
|
need for walking aid |
no |
0 |
|
|
wheelchair |
2 |
|
|
walker |
1 |
|
|
other |
0 |
|
feeling of security with walking aid |
no walking aid |
0 |
|
|
no |
0 |
|
|
yes |
1 |
|
hemiparesis |
no |
0 |
|
|
yes |
2 |
|
disorder of orientation |
no |
0 |
|
|
yes |
2 |
|
daily anticonvulsants |
no |
0 |
|
|
yes |
1 |
|
daily use of laxatives |
no |
0 |
|
|
yes |
1 |
|
urinary incontinence |
no |
0 |
|
|
yes, with permanent catheter |
1 |
|
|
yes, without permanent catheter |
3 |
|
somnolent state |
no |
0 |
|
|
yes |
-5 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -5 (authors say 1, but this may be the lowest score that they observed)
• maximum score: 22
|
Total Score |
Risk of Falls |
|
<= 5 |
low |
|
6 to 10 |
medium |
|
11 to 15 |
high |
|
16 to 22 |
very high |
Performance:
• The area under the ROC curve was 0.78.
Specialty: Surgery, orthopedic, Emergency Medicine
