Can Braden Score Predict Outcomes for Hospitalized Heart Failure Patients?

Bandle, Brian; Ward, Kelsey; Min, Sung‐Joon; Drake, Cynthia; McIlvennan, Colleen K.; Kao, David; Wald, Heidi L.

doi:10.1111/jgs.14801

Cited by 27 publications

(20 citation statements)

References 15 publications

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“…In addition to the variables we found to be independently associated with LOS, studies have also found independent relations between LOS and other variables as well. (21)(22)(23). However, limitations exist within these models.…”

Section: Discussionmentioning

confidence: 99%

“…For the ICDSC score, the sample size was too small and the relations between the score and LOS still need to be verified (22). Finally, the Braden Score might not be generalizable because it was developed through a single-center-study (23). A predictive risk model that is widely used in the assessment of LOS is still relatively lacking (in terms of, for example, considerations related to accuracy, specificity, and applicability), so it is important to develop a model with improved predictive ability.…”

Section: Discussionmentioning

confidence: 99%

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The utility of the adjusted-OPTIMIZE-HF risk model for predicting in-hospital length of stay in the Chinese population

Wang¹,

Wang²,

Zhang³

2021

Ann Palliat Med

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Background: Various risk scores exist for predicting in-hospital mortality in patients with heart failure (HF), including the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) risk model. However, the relations between these risk scores and length of in-hospital stay (LOS) in patients with acute decompensated heart failure (ADHF) has not received much attention. We aim to explore the relationship between the adjusted-OPTIMIZE-HF risk model and LOS in the Chinese population.Methods: This was a single-center, retrospective study that enrolled a total of 4,481 patients with ADHF.We investigated the relation between a wide range of patient variables present at hospital admission, including those that comprise the adjusted-OPTIMIZE-HF risk model and LOS (primary outcome). We divided patients into a short LOS (n=2,177, LOS <6 days) and a long LOS (n=2,304, LOS ≥6 days) group.We then explored the relations between the adjusted-OPTIMIZE-HF risk score and LOS using logistic regression, receiver operating characteristic (ROC) curves, and subgroup analyses.Results: A total of 4,481 people [61.6% male, median age 71 years (interquartile range, 16 years)] were included in this study. In univariate regression analyses, numerous variables were significantly different between the long and short LOS groups. Multivariate logistic regression showed that the adjusted-OPTIMIZE-HF risk score had a significant predictive ability for LOS (OR 1.248, 95% CI: 1.094-1.424), P=0.001). The results of the ROC curve analysis [area under the curve (AUC) 0.583, 95% CI: 0.567-0.600] demonstrated the potential value of the risk score for predicting LOS. Finally, subgroup analyses showed that the risk score was not only predictive of LOS in the overall population, but also in subgroups of patients defined by gender, history of smoking, history of drinking, presence of hypertension, and diabetes. Conclusions:The adjusted-OPTIMIZE-HF risk model performed well in predicting LOS greater than 6 days in the Chinese patients with ADHF. Moreover, the model proved to be stable across subgroup analyses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The utility of the adjusted-OPTIMIZE-HF risk model for predicting in-hospital length of stay in the Chinese population

Wang¹,

Wang²,

Zhang³

2021

Ann Palliat Med

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“…Overall, higher risk Braden scores were common in hospitalized heart failure patients but were not independent predictors of survival. Bandle et al also used the Braden score to evaluate whether it can predict outcomes including mortality, length of stay and discharge destination in a retrospective review of 642 heart failure patients 15 . After adjustment, higher Braden score was significantly associated with decreased 30‐day mortality (discharge Braden OR 0.81 [95% CI 0.66‐0.996]), decreased average LOS (admission Braden β −0.52 days [ P = .0002]) and associated with discharge to home (OR 1.66 [95% CI 1.42‐1.95]).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Braden scale in predicting surgical outcomes in older patients undergoing major head and neck surgery

Grewal

Sklar

Almeida

et al. 2020

Laryngoscope Investig Oto

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Background Being able to predict negative postoperative outcomes is important for helping select patients for treatment as well for informed decision‐making by patients. Frailty measures are often time and resource intensive to use as screening measures, whereas the Braden scale, a commonly used measure to assess patients at risk of developing pressure ulcers after surgery, may be a potential tool to predict postoperative complication rates and longer length of stay (LOS) in patients undergoing major head and neck cancer surgery. Methods A retrospective analysis of Braden scale scores was performed on a prospectively collected cohort of patients undergoing major head and neck surgery recruited between December 2011 and April 2014. The association of Braden scale score with the primary outcomes of complications and LOS was analyzed using logistic regression and linear regression models on univariate analysis (UVA), respectively. Multivariate analysis (MVA) was performed based on a backward stepwise selection algorithm. Results There were 232 patients with a mean (SD) Braden scale score of 14.9 (2.8) with a range from 9 to 23. The Braden scale (β = −.07 per point; 95% CI −0.09, −0.04, P < .001) was an independent predictor of increased LOS on UVA, but not on MVA when adjusted for other variables. For overall complications, as well as type of complication, the Braden scale score was not a significant predictor of complications on either UVA or MVA. Conclusion In the sample population, the Braden scale did not demonstrate an ability to predict negative outcomes in head and neck surgery patients. Level of Evidence Level 2b individual cohort study.

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“…Previous studies in different populations of hospitalized patients have shown that the BS may be associated with short-term mortality in acutely ill patients, especially with BS ≤ 15 (Bandle et al, 2017;Jentzer et al, 2019;Rothman, Solinger, Rothman, & Finlay, 2012;Sundaram et al, 2017). In the present study, we sought to examine BS as a potential marker of frailty in COVID-19 patients, defining its association with hospital mortality in this population after adjustment for other known outcome predictors.…”

Section: Introductionmentioning

confidence: 96%

Admission Braden Scale Score as an Early Independent Predictor of In‐Hospital Mortality Among Inpatients With COVID‐19: A Retrospective Cohort Study

Lovicu

Faraone

Fortini

2021

Worldviews Ev Based Nurs

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Background: The COVID-19 pandemic has put a strain on health systems. Predictors of adverse outcomes need to be investigated to properly manage COVID-19 patients. The Braden Scale (BS), commonly used for the assessment of pressure ulcer risk, has recently been proposed to identify frailty.Objective: To investigate the predictive utility of the BS for prediction of in-hospital mortality in a cohort of COVID-19 patients admitted to non-ICU wards.Methods: We conducted a retrospective single-center cohort study evaluating all patients with SARS-CoV-2 infection consecutively admitted over a 2-month period (from March 6 to May 7, 2020) to the COVID-19 general wards of our institution. Demographic, clinical, and nursing assessment data, including admission BS, were extracted from electronic medical records. Univariable and multivariable logistic regression models were used to explore the association between the BS score and in-hospital death.Results: Braden Scale was assessed in 146 patients (mean age 74.7 years; 52% males). On admission, 46 had a BS ≤ 15, and 100 patients had a BS > 15. Mortality among patients with BS ≤ 15 was significantly higher than in patients with BS > 15 (45.7% vs. 16%; p < .001). On multivariable regression analysis, adjusting for potentials confounders (age, Barthel scale, chronic kidney disease, atrial fibrillation, and hypertension), the admission BS remained inversely associated with the risk of in-hospital mortality (OR = 0.76; 95% CI [0.60, 0.96]; p = .020).Linking Evidence to Action: Admission BS could be used as a simple bedside predictive tool able to early identify non-ICU COVID-19 patients with poor prognosis who might benefit from specific and timely interventions.

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Can Braden Score Predict Outcomes for Hospitalized Heart Failure Patients?

Abstract: Braden score is an independent predictor of mortality, LOS, and discharge destination among inpatients with HF. Further exploration of the use of Braden scores to identify inpatients who might benefit from specialized intervention is warranted.

Cited by 27 publications

References 15 publications

The utility of the adjusted-OPTIMIZE-HF risk model for predicting in-hospital length of stay in the Chinese population

The utility of the adjusted-OPTIMIZE-HF risk model for predicting in-hospital length of stay in the Chinese population

Evaluation of the Braden scale in predicting surgical outcomes in older patients undergoing major head and neck surgery

Admission Braden Scale Score as an Early Independent Predictor of In‐Hospital Mortality Among Inpatients With COVID‐19: A Retrospective Cohort Study

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