Validation of the Second and Third Editions of the Child Fall Risk Assessment Tool for Pediatric Patients Using Cribs

Abstract

This prospective study aimed to clarify the validity of the second and third editions of the Child-Fall Risk Assessment Tool (C-FRAT) for pediatric patients using cribs. The study included 697 pediatric patients (mean age 2.4 years) currently using cribs. The number of assessments was 1,315, and the num-ber of reported falls was 51 (25 while walking, 26 from the crib). Two risk factors were significantly related to falls while walking, including wearing slippers or sandals (p=0.04, OR=4.3), can't watch out when child is running (p=0.02, OR=2.8). Two risk factors were significantly related to falls from cribs, including forgets to raise bed rails when leaving bedside (p<0.01, OR=9.7), improved physical symp-toms (p=0.04, OR=2.0). The most valid cutoff point for the second edition was 13, the area under the curve (AUC) was 0.81, and the sensitivity and specificity were 0.78 and 0.73, respectively. We devel-oped three alternative tools for the third edition of the assessment tool, using different weightings for the various risk factors. Each of our three new tools were analyzed using the second edition's research data, and the AUC for each new tool was found to be 0.83-0.84. We conclude that the second and third editions of the C-FRAT have moderate accuracy.