General Calculator

What is your risk?

The probability of you having at least one ED visit within the next 12 months:

Is this low, moderate, or high risk?

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What behavioral factors, medications, tobacco, and exercise are raising the risk of ED visit?

How the individual uses medications and cigarettes, and physical activity level:

How often is prescription medication used to treat conditions:

What other factors are related to the risk of ED visits:

What is your risk?

The probability of you having at least 1 ED hospitalization within the next 12 months:

Is this low, moderate, or high risk?

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What behavioral factors, medications, and exercise are raising the risk of ED hospitalization?

How the individual uses medications and physical activity level:

How often is prescription medication used to treat conditions:

What other factors are related to the risk of ED hospitalization:

What is your risk?

The probability of you having at least 1 unintentional fall related injury within the next 12 months:

Is this low, moderate, or high risk?

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Walking status

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What is raising my risk?

How I use medications and alcohol:

How often is prescription medication used to treat conditions:

Important note to user: Your risk of falls may result from the condition itself, rather than the actual medication. Always talk with your doctor or healthcare provider about your medication use before making changes. As your risk may be related to the underlying condition(e.g. pain, depression/anxiety, spasticity) rather than the medication itself.

What is your risk?

The probability of you having at least 1 unintentional unintentional Injury within the next 12 months:

Is this low, moderate, or high risk?

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Walking status

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Weight Status

What is raising my risk?

How I use medications and alcohol:

How often is prescription medication used to treat conditions:

Important note to user: Your risk of falls may result from the condition itself, rather than the actual medication. Always talk with your doctor or healthcare provider about your medication use before making changes. As your risk may be related to the underlying condition (e.g. pain, depression/anxiety, spasticity). rather than the medication itself.

What is your risk?

The probability of you having at least one pressure injury within the next 12 months:

Is this low, moderate, or high risk?

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What behavioral factors, medications, tobacco, and exercise are raising the risk of pressure injury?

How the individual uses medications and cigarettes, diet, and physical activity level:

How often is prescription medication used to treat conditions:

What other factors are related to the risk of pressure injuries:

What is the risk?

10%

How does this risk compare with others?

Ratio:

Min

Max

The respondent’s risk
Average risk

Min & Max: This places the individuals risk of at least 1 ED hispitalization in the next 12 months in the context of the average of all individuals with the same walking status, as walking status is highly related to ED visits. The minimum represents the lowest possible score for that walking status based on low-risk responses to the question; whereas the maximum score represents the highest possible score based on high-risk responses to the questions.

Low risk: includes all people who have a risk score of less than one half of standard deviation below the mean.
Moderate risk: includes all people who fall within one half of a standard deviation below or above the mean.
High risk: represents all people one half standard deviation or more above the mean.

Note:Healthcare providers should keep in mind that average risk is not typically the desired level of risk. People who have average risk are still at risk for ED visits. This is why those who are within one half standard deviation below the mean are still considered moderate risk. The goal is to reduce risk to an acceptable level.

Cut-off points for low, moderate, and high risks
Risk level	Low Risk	Moderate Risk	High Risk
Percentage	< 33.38%	33.38% - 48.65%	> 48.65%

■ The respondent’s risk category

What behavioral factors, medications, tobacco, and exercise are raising the risk of ED visits?

How the individual uses medications and cigarettes, and physical activity level:

How often is prescription medication used to treat conditions:

What other factors are related to the risk of ED visits:

Important note to user: The calculator cannot differentiate the extent to which the increased risk of ED visits relates to the medication per se versus the underlying condition. The percentage of added risk associated with each of the risk variables related to how the individual uses medications and alcohol and the frequency of use of prescription medication to treat conditions relate to each specific factor, holding all other things equal. It gives the relative importance of each factor. In unusual circumstances where individuals have a very large number of risk factors, the individual percentages may exceed the total risk probability of the ED visit. Therefore, the percentage of increased risk for each factor needs to be considered as a general indicator of risk. Race-Ethnicity is also realted to ED visits and other important outcomes.

What is the risk?

10%

How does this risk compare with others?

Ratio:

Min

Max

The respondent’s risk
Average risk

Min & Max: This places the individuals risk of at least one ED visit in the next 12 months in the context of the average of all individuals with the same walking status, as walking status is highly related to ED hospitalization. The minimum represents the lowest possible score for that walking status based on low-risk responses to the question; whereas the maximum score represents the highest possible score based on high-risk responses to the questions.

Low risk: includes all people who have a risk score of less than one half of standard deviation below the mean.
Moderate risk: includes all people who fall within one half of a standard deviation below or above the mean.
High risk: represents all people one half standard deviation or more above the mean.

Note:Healthcare providers should keep in mind that average risk is not typically the desired level of risk. People who have average risk are still at risk for ED hospitalization. This is why those who are within one half standard deviation below the mean are still considered moderate risk. The goal is to reduce risk to an acceptable level.

Cut-off points for low, moderate, and high risks
Risk level	Low Risk	Moderate Risk	High Risk
Percentage	< 15.45%	15.45% - 26.85%	> 26.85%

■ The respondent’s risk category

What behavioral factors, medications, and exercise are raising the risk of ED hospitalization?

How the individual uses medications and physical activity level:

How often is prescription medication used to treat conditions:

What other factors are related to the risk of ED hospitalization:

Important note to user: The calculator cannot differentiate the extent to which the increased risk of ED hospitalization relates to the medication per se versus the underlying condition. The percentage of added risk associated with each of the risk variables related to how the individual uses medications and alcohol and the frequency of use of prescription medication to treat conditions relate to each specific factor, holding all other things equal. It gives the relative importance of each factor. In unusual circumstances where individuals have a very large number of risk factors, the individual percentages may exceed the total risk probability of the ED visit. Therefore, the percentage of increased risk for each factor needs to be considered as a general indicator of risk. Race-Ethnicity is also realted to ED hospitalization and other important outcomes.

What is the risk?

10%

How does this risk compare with others?

Ratio:

Min

Max

The respondent’s risk
Average risk

Min & Max: This places the individual’s risk of at least 1 fall related injury in the next 12 months in the context of the average of all individuals with the same walking status, as walking status is highly related to fall related injuries. The minimum represents the lowest possible score for that walking status based on low-risk responses to the question; whereas the maximum score represents the highest possible score based on high-risk responses to the questions.

Low risk: includes all people who have a risk score of less than one half of standard deviation below the mean.
Moderate risk: includes all people who fall within one half of a standard deviation below or above the mean.
High risk: represents all people one half standard deviation or more above the mean.

Note:Healthcare providers should keep in mind that average risk is not typically the desired level of risk. People who have average risk are still at risk for fall related injuries. This is why those who are within one half standard deviation below the mean are still considered moderate risk. The goal is to reduce risk to an acceptable level.

Cut-off points for low, moderate, and high risks as a function of ambulatory status
Walking Status	Low Risk	Moderate Risk	High Risk
I can not walk at all	< 5.59%	5.59% - 10.78%	> 10.78%
I can walk without other's assistance	< 9.38%	9.38% - 17.29%	> 17.29%
I can walk, but need at least one person's assistance	< 20.36%	20.36% - 32.65%	> 32.65%

■ The respondent’s risk category

Note: The table breaks down the risk categories according to ambulatory status. Those who are ambulatory are at greater risk of fall related injuries and those who ambulate with the assistance of another individual are at the highest risk. The calculator does not account for reliance on devices. People who ambulate with assistance from another typically also rely on devices, so the calculator may be used in conjunction with other measures of walking.

Walking Status

walk_status_res:
walk_status_res_exp:

what behavioral and medication factors are raising the risk of fall related injuries?

How the individual uses medications and alcohol:

How often is prescription medication used to treat conditions:

Important note to user: The calculator cannot differentiate the extent to which the increased risk of falls relates to the medication per se versus the underlying condition. The percentage of added risk associated with each of the risk variables related to how the individual uses medications and alcohol and the frequency of use of prescription medication to treat conditions relate to each specific factor, holding all other things equal. It gives the relative importance of each factor. In unusual circumstances where individuals have a very large number of risk factors, the individual percentages may exceed the total risk probability of the fall related injury. Therefore, the percentage of increased risk for each factor needs to be considered as a general indicator of risk.

What is the risk?

10%

How does this risk compare with others?

Ratio:

Min

Max

The respondent’s risk
Average risk

Low risk: includes all people who have a risk score of less than one half of standard deviation below the mean.
Moderate risk: includes all people who fall within one half of a standard deviation below or above the mean.
High risk: represents all people one half standard deviation or more above the mean.

Note:Healthcare providers should keep in mind that average risk is not typically the desired level of risk. People who have average risk are still at risk for fall related injuries. This is why those who are within one half standard deviation below the mean are still considered moderate risk. The goal is to reduce risk to an acceptable level.

Cut-off points for low, moderate, and high risks as a function of ambulatory status
Walking Status	Low Risk	Moderate Risk	High Risk
I can not walk at all	< 17.58%	17.58% - 27.12%	> 27.12%
I can walk without other's assistance	< 18.11%	18.11% - 28.49%	> 28.49%
I can walk, but need at least one person's assistance	< 29.02%	29.02% - 42.06%	> 42.06%

■ The respondent’s risk category

Note: The table breaks down the risk categories according to ambulatory status. Those who ambulate with assistance of another individual are at a higher risk than either wheelchair users or those who ambulate independently. The calculator does not account for reliance on devices. People who ambulate with assistance from another typically also rely on devices, so the calculator may be used in conjunction with other measures of walking.

Walking Status

walk_status_res:
walk_status_res_exp:

Weight Status

What behavioral and medication factors are raising the risk of fall related injuries?

How the individual uses medications and alcohol:

How often is prescription medication used to treat conditions:

Important note to user: The calculator cannot differentiate the extent to which the increased risk of injuries relates to the medication per se versus the underlying condition. The percentage of added risk associated with each of the risk variables related to how the individual uses medications and alcohol and the frequency of use of prescription medication to treat conditions relate to each specific factor, holding all other things equal. It gives the relative importance of each factor. In unusual circumstances where individuals have a very large number of risk factors, the individual percentages may exceed the total risk probability of the fall related injury. Therefore, the percentage of increased risk for each factor needs to be considered as a general indicator of risk.

What is the risk?

10%

How does this risk compare with others?

Ratio:

Min

Max

The respondent’s risk
Average risk

Min & Max: This places the individuals risk of at least one pressure injury in the next 12 months in the context of the average of all individuals with the same walking status, as walking status is highly related to pressure injuries. The minimum represents the lowest possible score for that walking status based on low-risk responses to the question; whereas the maximum score represents the highest possible score based on high-risk responses to the questions.

Low risk: includes all people who have a risk score of less than one half of standard deviation below the mean.
Moderate risk: includes all people who fall within one half of a standard deviation below or above the mean.
High risk: represents all people one half standard deviation or more above the mean.

Note:Healthcare providers should keep in mind that average risk is not typically the desired level of risk. People who have average risk are still at risk for pressure injuries. This is why those who are within one half standard deviation below the mean are still considered moderate risk. The goal is to reduce risk to an acceptable level.

Cut-off points for low, moderate, and high risks
Risk level	Low Risk	Moderate Risk	High Risk
Percentage	< 23.69%	23.69% - 42.54%	> 42.54%

■ The respondent’s risk category

What behavioral factors, medications, tobacco, and exercise are raising the risk of pressure injuries?

How the individual uses medications and cigarettes, diet, and physical activity level:

How often is prescription medication used to treat conditions:

What other factors are related to the risk of pressure injuries:

Important note to user: The calculator cannot differentiate the extent to which the increased risk of pressure injuries relates to the medication per se versus the underlying condition. The percentage of added risk associated with each of the risk variables related to how the individual uses medications and alcohol and the frequency of use of prescription medication to treat conditions relate to each specific factor, holding all other things equal. It gives the relative importance of each factor. In unusual circumstances where individuals have a very large number of risk factors, the individual percentages may exceed the total risk probability of the pressure injury. Therefore, the percentage of increased risk for each factor needs to be considered as a general indicator of risk. Race-Ethnicity is also realted to pressure injuries and other important outcomes.

This is a tool to help you understand the risk of: 1) having to visit the emergency department (ED), 2) ED related hospitalization in the next 12 months, 3) life expectancy, 4) fall related injuries, and 5) all injuries among people with spinal cord injury (SCI).

This tool is based on our cross-sectional study of 4,670 people with SCI. Since those with SCI have a higher rate of ED visits and hospitalizations, lower life expectancy, and higher rates of unintentional and all injuries, our purpose was to identify the various predictors of ED visits and hospitalizations, estimate life expectancy, and show the probability of having a fall or non-fall related injury in a 12-month time frame among individuals with SCI. Because the data were collected at a single point in time, we cannot determine cause and effect.

The estimates are based on our research and give a general idea of life expectancy, what places people with SCI at risk for ED visits, and what places people with SCI at risk for unintentional injuries. Because findings vary from study to study, the estimates are only to give a general idea of an individual’s risk compared to that of others with similar characteristics. It also will help people to see how they can reduce their risk of ED visits, increase life expectancy, and reduce risks of unintentional injuries. If you have concerns about your ED visits or hospitalizations, life expectancy, or unintentional injuries and what you can do to improve your health, quality of life, or longevity, you should talk to your healthcare provider.

Our Emergency Department Calculator used the following factors:
1. Sex (Male, Female)
2. Current age
3. Years post-injury
4. Walking status
5. SCI neurological level
6. Race/ethnicity, we use a combination of race-ethnicity and because of limitations in our data, it is analyzed in three groups: non-Hispanic White, non-Hispanic Black, and Other, which includes Hispanic, Asian, Native Hawaiian, Pacific Islander, American Indian, Alaskan Native. We use the “other” category because there were not enough participants in any group, other than non-Hispanic White and non-Hispanic Black, to form individual categories.
7. Household income
8. Weight status
9. Diet
10. Alcohol misuse
11. Non-medical substance misuse
12. Frequency of prescription medication usage
13. Prescription medication misuse
14. Cigarette smoking
15. Exercise

Source of data: The data upon which the calculations are based are taken from studies of emergency department visits (Cao, DiPiro, & Krause, 2021), socioeconomic factors and life-expectancy (Krause, Saunders, & Acuna, 2012), and behavioral factors and unintentional injuries (Cao, DiPiro, Li, Roesler, & Krause, 2019).

Calculator limitations:
There are factors that relate to risk of ED visits and ED related hospitalizations, life expectancy, and unintentional injuries that are not accounted for within this formula. We are unable to include other factors because we have used findings from a single study.

DISCLAIMER: You should NEVER base healthcare or other important decisions solely on individualized calculators or other types of printer online materials. This calculator is only intended to be one tool to help you understand how certain factors relate to important outcomes – risk of ED visits or hospitalizations, life expectancy, and unintentional injuries. You should ALWAYS consult your physician or other healthcare provider if you have questions or concerns regarding your health, quality of life, or longevity. Talk with your doctor or healthcare provider before making any changes to your use of medications.

Reference:
Cao, Y., DiPiro, N.D., & Krause, J.S. (2021). Emergency department visits and related hospitalizations after traumatic spinal cord injury. Spinal Cord, doi: 10.1016/j.apmr.2021.02.030

Krause, J. S., Saunders, L. L., & Acuna, J. (2012). Gainful employment and risk of mortality after spinal cord injury: effects beyond that of demographic, injury and socioeconomic factors. Spinal Cord, 50, 784-788. doi: 10.1038/sc.2012.49

Cao, Y., DiPiro, N.D., Li, C., Roesler, J., & Krause, J.S. (2020). Behavioral factors and unintentional injuries after spinal cord injury. Archives of Physical Medicine and Rehabilitation, (101):412-7