SCI Fall-Related Unintentional Injury Calculator

Fall Related Injury Calculator

For Persons with Spinal Cord Injury

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 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.

This is a tool to help you understand the risk of unintentional injuries due to falls among people with spinal cord injury (SCI). Unintentional injuries are unplanned and unexpected. Examples include broken bones, dislocations, burns, and cuts.

This tool is based on our cross-sectional study of 4670 people with SCI. It focuses on unintentional injuries that happen as a result of a fall where one has been injured seriously enough to receive medical care in a clinic, emergency room, or hospital. This calculator shows the probability of having at least one unintentional injury due to fall in a 12 month time frame. This is based on identifying how other people with SCI who have answered the same basic questions. Because the data were collected at a single point in time, we cannot determine cause and effect.

The estimates are based on our research give a general idea of risk and what places people with SCI at risk for unintentional injuries. They will help people see how likely, they are on average, to have an unintentional injury due to a fall based on a number of factors, including health behaviors. 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 unintentional injuries.

Our Unintentional Injuries Due To Falls 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.
7. Household income
8. Weight status
9. Alcohol misuse
10. Non-medical substance misuse
11. Frequency of prescription medication usage
12. Prescription medication misuse

Source of data: The data upon which the calculations are based are taken from a study of behavioral factors and unintentional injuries (Cao, DiPiro, Li, Roesler, and Krause, 2019).

Calculator limitations:
There are factors that relate to risk of unintentional injuries due to falls 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: Your risk of an unintentional fall may relate to your health condition or your medications you are taking to treat the condition. Talk with your doctor or healthcare provider before making any changes to your use of medications.

This calculator is only intended to be one tool to help you understand how certain factors relate to an important outcome – unintentional injuries due to falls. You should NEVER base healthcare or other important decisions solely on individualized calculators or other types of printed or online materials. You should consult your doctor or other healthcare provider if you have questions or concerns regarding your health, quality of life, or longevity.

Reference:
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