The predictive validity of the Hessisch Oldendorf Risk of Falling Scale (HOSS) decreases during the course of rehabilitation

Article type: Research Article

Authors: Schmidt, Simone B.^* | Boltzmann, Melanie | Rollnik, Jens D.

Affiliations: BDH-Clinic Hessisch Oldendorf, Institute of Neurorehabilitation Research, Associated Institute of the Hanover Medical School, Hessisch Oldendorf, Germany

Correspondence: [*] Address for correspondence: Simone B. Schmidt, BDH-Kli-nik Hessisch Oldendorf, Greitstr. 18-28, 31840 Hessisch Oldendorf, Germany. E-mail: [email protected].

Abstract: BACKGROUND:Falls are highly frequent among neurological patients during rehabilitation and subsequent risk assessments are crucial to prevent falls. OBJECTIVE:This study aims to determine the predictive values of the Hessisch Oldendorf Risk of Falling Scale (HOSS, “Hessisch Oldendorfer Sturzrisiko Skala”) for two timeframes: the first month of rehabilitation and from the second month to the end of rehabilitation. METHODS:Scale performances were assessed for 512 patients during inpatient neurological rehabilitation by calculating the sensitivity and the specificity. HOSS items were entered into a binary logistic regression model. Fall rates were calculated and used for correlation analyses and group comparisons. RESULTS:Initial HOSS assessment showed a sensitivity of 80.4% and a specificity of 60.7%. The HOSS re-assessment resulted in a sensitivity of 67.3% and a specificity of 69.5%. Only a non-somnolent state was identified to increase the risk of falling in both timeframes. Patients with a moderate impaired functional status (Barthel-Index between 20 and 50 points) showed the highest fall rates. CONCLUSION:The predictive validity of the HOSS decreases during the rehabilitation course. This might be caused by an altered relevance of the HOSS items during the re-assessment compared to the initial assessment for which the HOSS was developed for.

Keywords: Hessisch oldendorf risk of falling scale, HOSS, risk of falling, neurological rehabilitation, risk assessment, re-assessment, rehabilitation course

DOI: 10.3233/NRE-210228

Journal: NeuroRehabilitation, vol. 50, no. 4, pp. 485-491, 2022