Introduction: Older adult (≥65 years) falls are common and may result in severe injuries. There is limited knowledge about what proportion of older adults who fall sustain injuries that need medical attention. Screening is the first step in helping older adults reduce their risk of falls. However, there is limited research on how well current fall screeners can predict fall injuries.

Methods: Previously collected data from community-dwelling older adults enrolled in a 13-month long study, from the AmeriSpeak Panel, were analyzed. Baseline survey included questions related to demographics, falls risk factors, and falls risk screeners (CDC's 3 Key Questions (3KQ) and Stay Independent). Weighted percentages and 95% confidence intervals (CI) of older adults reporting one or more falls, fall-related injuries, falls needing any medical attention, falls resulting in doctor visits, and falls resulting in Emergency Department (ED) visits and/or hospitalization by demographics and fall risk factors were calculated. Risk ratios, sensitivity, specificity, and positive and negative predictive values were calculated to compare the two screeners' ability to predict fall injury outcomes.

Results: Among older adults who fell, 24.8% had an injury resulting in any medical attention, 14.5% sought treatment at a doctor's office, and 14.3% sought treatment at an ED/hospital. Sensitivity estimates for baseline 3KQ and Stay Independent screeners for falls resulting in an ED/hospital visit were 87.3% and 75.0%, respectively. Specificity estimates were 47.4% and 63.6%.

Conclusion: At least one in four older adults who fell needed medical attention. The 3KQ or Stay Independent screeners identified a large proportion of older adults who sought treatment at an ED/hospital for falls. However, using them may result in a large number of false positives.

Practical application: Clinicians may use these screeners to identify older adults at high fall injury risk, assess them for specific risk factors, and intervene accordingly.

Keywords: Aged; Emergency care; Fall risk Screener; Sensitivity; Specificity.

Copyright © 2025 National Safety Council and Elsevier Ltd. All rights reserved.

简介： 老年人（≥65岁）跌倒是常见的，可能导致严重的伤害。关于需要医疗关注的跌倒受伤比例的老年群体的知识有限。筛查是帮助老年人降低跌倒风险的第一步。然而，目前研究对现有跌倒筛查工具预测跌伤效果的研究较少。

方法： 分析了来自AmeriSpeak Panel的社区居住老年人在一项为期13个月的研究中先前收集的数据。基线调查包括与人口统计学、跌倒风险因素和跌倒风险筛查工具（CDC的三个关键问题 (3KQ) 和Stay Independent）相关的问题。计算不同人口统计特征和跌倒风险因素下报告一次或多次跌倒、跌倒相关的伤害、需要任何医疗关注的跌倒、导致医生就诊的跌倒以及导致急诊科(ED)/住院的跌倒的加权百分比和95%置信区间（CI）。计算风险比、灵敏度、特异性和阳性及阴性预测值，以比较两种筛查工具预测跌伤结局的能力。

结果： 在老年人中，有24.8%的跌倒导致了任何程度的医疗关注，14.5%的人寻求医生处治疗，14.3%的人前往急诊科/医院就诊。基线3KQ和Stay Independent筛查工具对跌倒引发急诊科/住院就诊的敏感性分别为87.3% 和75.0%，特异性分别为47.4% 和63.6%。

结论： 至少有四分之一的老年人在跌倒后需要医疗关注。使用3KQ或Stay Independent筛查工具可以识别大量寻求急诊科/医院治疗的老年人，但是可能会导致大量的假阳性结果。

实际应用： 临床医生可以利用这些筛查工具来识别高跌伤风险的老年人，评估他们的特定风险因素，并采取相应的干预措施。

关键词： 老年；急诊护理；跌倒风险筛查器；灵敏度；特异性。