Predictive Validity of the Braden Scale for Patients in Intensive Care Units

Abstract

Background Patients in intensive care units are at higher risk for development of pressure ulcers than other patients. In order to prevent pressure ulcers from developing in intensive care patients, risk for development of pressure ulcers must be assessed accurately. Objectives To evaluate the predictive validity of the Braden scale for assessing risk for development of pressure ulcers in intensive care patients by using 4 years of data from electronic health records. Methods Data from the electronic health records of patients admitted to intensive care units between January 1, 2007, and December 31, 2010, were extracted from the data warehouse of an academic medical center. Predictive validity was measured by using sensitivity, specificity, positive predictive value, and negative predictive value. The receiver operating characteristic curve was generated, and the area under the curve was reported. Results A total of 7790 intensive care patients were included in the analysis. A cutoff score of 16 on the Braden scale had a sensitivity of 0.954, specificity of 0.207, positive predictive value of 0.114, and negative predictive value of 0.977. The area under the curve was 0.672 (95% CI, 0.663–0.683). The optimal cutoff for intensive care patients, determined from the receiver operating characteristic curve, was 13. Conclusions The Braden scale shows insufficient predictive validity and poor accuracy in discriminating intensive care patients at risk of pressure ulcers developing. The Braden scale may not sufficiently reflect characteristics of intensive care patients. Further research is needed to determine which possibly predictive factors are specific to intensive care units in order to increase the usefulness of the Braden scale for predicting pressure ulcers in intensive care patients.

Análise de eventos adversos em pacientes internados em unidade de terapia intensiva

“…(12) However, the values found are in agreement with another study that addressed AE in ICUs. (7) These variables depend on several factors, such as severity of disease and therapeutic requirements resulting from eventual complications.…”

Risco de integridade da pele prejudicada: avaliação e conduta de enfermagem frente às úlceras por pressão (UPP) em pacientes em terapia intensiva

“…Encontramos descritas algumas intervenções preventivas, principalmente executadas pela equipe de enfermagem, envolvendo o uso de colchões adequados ao alívio da pressão e mudanças de decúbito, embora ocorra risco de instabilidade hemodinâmica no paciente críti-co (BAUMGARTEN et al, 2008;KURC-GANT, 2012b;HYUN et al, 2013). Deve ser adotada por toda a equipe de saúde uma maior vigilância na primeira semana de internação, momento de maior alteração fi siológica do paciente e com probabilidade elevada de lesões (COX, 2011).…”

Investigation of the risk factors of pressure ulcers in intensive care unit patients: According to the Braden Scale

“…Therefore, risk assessment is very important to identify of patients who are at high risk of developing PU in ICUs, in order to encourage effective PU management (21,22). PU risk assessment scales recently are used widespread in ICUs for preventing PUs in the patients (22). In various studies examined validity and reliability of the following scales such as Braden and Waterlow (21).…”

“…In various studies examined validity and reliability of the following scales such as Braden and Waterlow (21). PU risk assessment scales recently are used widespread in ICUs for preventing PUs in the patients (22). In various studies examined validity and reliability of the following scales such as Braden and Waterlow (21).…”

“…The incidence of PUs in the neurology intensive care unit was reported to be 18.3% in the study of Kurtuluş and Pınar (16), 4.8% in the surgery intensive care unit in the study of Karadağ and Gümüşkaya (17), 11.6% in the 2 study of Uzun and Tan (18), 14.3% in the study of Sayar et al (19) and 10.4% in the study of Inan and Oztunc (20). Therefore, risk assessment is very important to identify of patients who are at high risk of developing PU in ICUs, in order to encourage effective PU management (21,22). PU risk assessment scales recently are used widespread in ICUs for preventing PUs in the patients (22).…”