Braden Skin Score Subdomains Predict Mortality Among Cardiac Intensive Care Patients

Brueske, Benjamin; Sidhu, Mandeep S.; Chang, Isabella Y; Wiley, Brandon M.; Murphy, Joseph G.; Bennett, Courtney; Barsness, Gregory W.; Jentzer, Jacob C.

doi:10.1016/j.amjmed.2022.01.046

Cited by 2 publications

(4 citation statements)

References 24 publications

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“…In older patients with low Braden scores, these problems may further affect the neurological function of older patients, resulting in their brains being vulnerable to various internal and external factors, thus increasing the risk of delirium (Hayhurst et al., 2016). Third, previous studies have validated that Braden scores can provide some indication of an individual's frailty (Brueske et al., 2022; Watkins et al., 2019). The association between frailty, especially in older patients, and the risk of delirium has been confirmed by numerous studies (Hubbard et al., 2017; Lim et al., 2023; Zhang et al., 2021).…”

Section: Discussionmentioning

confidence: 93%

Can admission Braden skin score predict delirium in older adults in the intensive care unit? Results from a multicenter study

Cheng,

Huang,

Yuan

et al. 2023

Journal of Clinical Nursing

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Aims and ObjectivesTo investigate whether a low Braden Skin Score (BSS), reflecting an increased risk of pressure injury, could predict the risk of delirium in older patients in the intensive care unit (ICU).BackgroundDelirium, a common acute encephalopathy syndrome in older ICU patients, is associated with prolonged hospital stay, long‐term cognitive impairment and increased mortality. However, few studies have explored the relationship between BSS and delirium.DesignMulticenter cohort study.MethodsThe study included 24,123 older adults from the Medical Information Mart for Intensive Care IV (MIMIC‐IV) database and 1090 older adults from the eICU Collaborative Research Database (eICU‐CRD), all of whom had a record of BSS on admission to the ICU. We used structured query language to extract relevant data from the electronic health records. Delirium, the primary outcome, was primarily diagnosed by the Confusion Assessment Method for the ICU or the Intensive Care Delirium Screening Checklist. Logistic regression models were used to validate the association between BSS and outcome. A STROBE checklist was the reporting guide for this study.ResultsThe median age within the MIMIC‐IV and eICU‐CRD databases was approximately 77 and 75 years, respectively, with 11,195 (46.4%) and 524 (48.1%) being female. The median BSS at enrollment in both databases was 15 (interquartile range: 13, 17). Multivariate logistic regression showed a negative association between BSS on ICU admission and the prevalence of delirium. Similar patterns were found in the eICU‐CRD database.ConclusionsThis study found a significant negative relationship between ICU admission BSS and the prevalence of delirium in older patients.Relevance to Clinical PracticeThe BSS, which is simple and accessible, may reflect the health and frailty of older patients. It is recommended that BSS assessment be included as an essential component of delirium management strategies for older patients in the ICU.No Patient or Public ContributionThis is a retrospective cohort study, and no patients or the public were involved in the design and conduct of the study.

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Section: Discussionmentioning

confidence: 93%

Can admission Braden skin score predict delirium in older adults in the intensive care unit? Results from a multicenter study

Cheng,

Huang,

Yuan

et al. 2023

Journal of Clinical Nursing

View full text Add to dashboard Cite

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“…The study used the Braden score on admission to the ICU as the exposure factor, which was also the initial score recorded when the patient was admitted to the ICU 10 . This is a scale specifically designed to assess a patient's risk of skin pressure injury.…”

Section: Methodsmentioning

confidence: 99%

“…The study used the Braden score on admission to the ICU as the exposure factor, which was also the initial score recorded when the patient was admitted to the ICU. 10 This is a scale specifically designed to assess a patient's risk of skin pressure injury. It combines six key risk components: Sensory, Moisture, Activity, Mobility, Nutrition and Friction/Shear (Supplementary Table S1).…”

Section: Exposure (Braden Score)mentioning

confidence: 99%

“…8 Since its inception in 1987, the scale has been widely recognized as a reliable bedside tool for predicting the risk of skin pressure injuries (or pressure ulcers), with scoring indicators in 6 dimensions. 9 As studies have deepened, the Braden score has also shown its value in other areas, such as predicting mortality in cardiac intensive care patients 10 and prognosis in hospitalised patients with heart failure. 11 However, research on the effectiveness of the Braden score as a prognostic tool for critically ill patients with dementia is limited.…”

Section: Introductionmentioning

confidence: 99%

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Braden score can independently predict 90‐day mortality in critically ill patients with dementia

Cheng,

Li,

Liang

et al. 2024

Int J Geriat Psychiatry

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BackgroundDementia is a significant cause of death in the older population and is becoming an important public health issue as the population ages and the prevalence of dementia increases. The Braden score is one of the most commonly used clinical tools to assess the risk of skin pressure injury in patients, and some studies have reported that it may reflect the state of frailty of patients. The present study attempted to explore the association between Braden score and 90‐day mortality, pressure injury, and aspiration pneumonia in older patients with dementia in the intensive care unit (ICU).MethodsThe study involved extracting crucial data from the Medical Information Market for Intensive Care IV (MIMIC‐IV) database using Structured Query Language, with a license certificate obtained after completing the necessary training and examination available on the MIMIC‐IV website. A retrospective analysis was performed on older patients with dementia, aged 65 or older, who were first admitted to the ICU. Ninth and tenth revision International Classification of Diseases codes were used to identify patients with dementia. The primary outcome was 90‐day mortality. Cox proportional hazards models were used to determine the association between Braden score and death, and hazard ratios (HR) and 95% confidence intervals (CI) were calculated. Propensity score matching and E‐value assessments were employed for sensitivity analysis.ResultsA total of 2892 patients with a median age of approximately 85 years (interquartile range 78.74–89.59) were included, of whom 1625 were female (56.2%). Patients had a median Braden score of 14 (interquartile range 12–15) at ICU admission. Braden score at ICU admission was inversely associated with 90‐day mortality risk after adjustment for demographics, severity of illness, treatment and medications, delirium, and sepsis (adjusted HR: 0.92, 95% CI: 0.87–0.98, p = 0.006). Patients were divided into two groups with a cut‐off value of 15: high‐risk group and low‐risk group. Compared to the low‐risk group (Braden score >15), the risk of 90‐day mortality was significantly increased in the high‐risk group (Braden score ≤15) (adjusted HR: 1.52, 95% CI: 1.10–2.09, p = 0.011, E‐value: 2.01), the risk of pressure injury (adjusted OR: 2.62, 95% CI: 2.02–3.43, E‐value: 2.62) and aspiration pneumonia (adjusted OR: 2.55, 95% CI: 1.84–3.61, E‐value: 2.57) was also significantly higher.ConclusionsThe Braden score may be a quick and simple screening tool to identify the risk of adverse outcomes in critically ill older adults with dementia.

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Braden Skin Score Subdomains Predict Mortality Among Cardiac Intensive Care Patients

Cited by 2 publications

References 24 publications

Can admission Braden skin score predict delirium in older adults in the intensive care unit? Results from a multicenter study

Can admission Braden skin score predict delirium in older adults in the intensive care unit? Results from a multicenter study

Braden score can independently predict 90‐day mortality in critically ill patients with dementia

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