<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1988-348X</journal-id>
<journal-title><![CDATA[Ene]]></journal-title>
<abbrev-journal-title><![CDATA[Ene.]]></abbrev-journal-title>
<issn>1988-348X</issn>
<publisher>
<publisher-name><![CDATA[Martín Rodríguez Álvaro]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1988-348X2023000300011</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Revisión de la validez de las escalas de valoración del riesgo de caídas en pacientes hospitalizados. [Evidencia comentada]]]></article-title>
<article-title xml:lang="en"><![CDATA[Review of the validity of fall risk assessment scales in hospitalised patients [Commented evidence]]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mateo-Cervera]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernández-Carrasco]]></surname>
<given-names><![CDATA[Susana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario de Navarra  ]]></institution>
<addr-line><![CDATA[Pamplona ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>17</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1988-348X2023000300011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1988-348X2023000300011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1988-348X2023000300011&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[resumen está disponible en el texto completo]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction. Patiente falls account for up to 70% of accidents in hospitalized patients. Due to the risk of significant injuries and the increased costs to the healthcare system, reducing falls in hospitals is one of the top priorities for hospital quality and patient safety. The causes of falls have a multifactorial etiology, which complicates the classification of fall risk. Nowadays, it is common practice to incorporate fall risk prediction scales in hospitals, usually carried out by nursing professionals as part of patient safety strategies. However, their validity and accuracy in this environment have not been clearly established, and there is uncertainty about which tool performs best in this regard.  Objective: The aim of this revisión is to analyze the validity of different assessment scales of the risk of falls in adults in the hospital enviromentcriterio, and especially in older patients.  Methods, data sources. The research question includes the following criterion:    population: hospitalized patients  predictive factor/model: fall risk rating scales  outcome variable: fall  time and environment: during hospital stay, in acute units The scales considered for this revisión were the Downton, Morse, Stratify, Hendrich and Tinetti scales, all of them designed to evaluate the risk of falls in the hospital environment. After a search of systematic revisions, it was completed with individual studies. Studies focused on mediumor long-stay hospitalization units were excluded. The subgroup of elderly patients was analyzed separately, selecting data from those studies carried out only in elderly patients or those who provided separate data for this subgroup. From each study, were extracted, the scale used and the cut-off point to consider the high-risk patient, the country, the study design, the type of patient or service where it was performed, the range and average age of the patients, sex, average stay, the source from which the falls were recorded, the number of patients with falls and the study population, true and false positives, and true and false negatives. Sensitivity and specificity are considered in this revision as measures of the predictive validity of the scales. The unit tested in all cases was the number of patients (never the number of falls).  Results. Thirty six primary studies were identified that analyzed the validity of the different assessment scales in acutely hospitalized adult patients: Stratify, Morse, Hendrich II, Downton and Tinetti. They included a total of 474,437 participants. Most of the studies were prospective (n = 27), and nine of them were retrospective. The age range of the participants was between 40 and 83 years. The average stay varied between 3 and 32 days, and the percentage of patients who suffered falls during admission varied between 0.18% and 25%. The studies were generally performed in different medical and surgical services. When analyzing the validity of different scales applied to adults in acute care hospital units, it was found that, in comparison to the Downton scale, the Morse scale generally exhibits better sensitivity and specificity. Similarly, the Stratify scale showed better sensitivity and specificity than the Downton scale, but it was slightly inferior to the Morse scale in both parameters. The Hendrich II scale demonstrated sensitivity similar to the Morse scale, with slightly higher specificity than the Downton scale but somewhat lower than both the Morse and Stratify scales. Only one study analyzed the Tinetti scale, showing high sensitivity but very low specificity. After the sensitivity analysis, the Morse scale would still maintain overall superior validity compared to the others.  Recommendations.    The correct use of risk evaluation tools requires time, experience and clinical judgment, and training of the personnel who perform them is necessary.  The high variability in the found results suggests the need to assess the performance of these tools in each specific context where they are intended to be used. The widespread adoption of a single scale as the reference standard cannot be recommended  The Clinical Best Practice Guideline for Preventing Falls and Reducing Injuries from Falls (International Affairs &amp; Best Practice) recommends evaluating all hospitalized adults to identify those who are at risk. In those with a positive screening, a comprehensive assessment is recommended, and validated tools can be used.  In older people, most guidelines recommend periodically evaluating the risk of falls and proposing interventions adapted to the risk of falling.  NICE (National Institute for Health and Care Excellence) guidelines do not recommend using risk prediction tools to evaluate the risk of falls in older hospitalized patients. Instead, they suggest considering all hospitalized patients aged 65 or older to be at high risk for falls, as well as patients aged 50 or older with underlying illnesses.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Caídas]]></kwd>
<kwd lng="es"><![CDATA[Valoración del riesgo]]></kwd>
<kwd lng="es"><![CDATA[Escalas]]></kwd>
<kwd lng="es"><![CDATA[Metaanálisis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bueno-García]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Roldán-Chicano]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez-Tello]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Meroño-Rivera]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Dávila-Martínez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Berenguer-García]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Characteristics of the Downton fall risk assessment scale in hospitalised patients]]></article-title>
<source><![CDATA[Enferm Clin]]></source>
<year>2017</year>
<volume>27</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>227-34</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="">
<collab>Worid Health Organization</collab>
<source><![CDATA[Ca&#305;das]]></source>
<year>2012</year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aranda-Gallardo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Morales-Asencio]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Canca-Sánchez]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Morales-Fernández]]></surname>
<given-names><![CDATA[Á]]></given-names>
</name>
<name>
<surname><![CDATA[Enríquez de Luna-Rodríguez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Moya-Suarez]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
<name>
<surname><![CDATA[Mora-Banderas]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez-Jiménez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Barrero-Sojo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Consecuencias de los errores en la traducción de cuestionarios: versión española del índice Downton]]></article-title>
<source><![CDATA[Rev Calid Asist]]></source>
<year>2015</year>
<volume>30</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>195-202</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<source><![CDATA[Guía prevención de caídas y disminución de lesiones derivadas de las caídas]]></source>
<year></year>
<publisher-name><![CDATA[RNAO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Casas Herrero]]></surname>
<given-names><![CDATA[Á]]></given-names>
</name>
<name>
<surname><![CDATA[Cadore]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Velilla]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Izquierdo Redin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El ejercicio físico en el anciano frágil: una actualización]]></article-title>
<source><![CDATA[Rev Esp Geriatr Gerontol]]></source>
<year>2015</year>
<volume>50</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>74-81</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
