Validez predictiva y fiabilidad de la escala de Braden para valoración del riesgo de úlceras por presión en una unidad de cuidados intensivos

Lima‐Serrano, Marta; González-Méndez, María Isabel; Martín-Castaño, C.; Alonso-Araujo, I.; Lima-Rodríguez, Joaquín Salvador

doi:10.1016/j.medin.2016.12.014

Cited by 26 publications

(13 citation statements)

References 22 publications

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“…Earlier studies 15–17 indicated that the Braden Scale lacks predictive validity among critical care patients, and therefore the scale is sometimes considered a care-planning tool in the intensive care unit rather than a risk-assessment tool. However, our findings suggest that the Braden Scale is not a useful tool for guiding care planning for patients who already have a stage 1 pressure injury.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study

Alderden¹,

Zhao²,

Zhang³

et al. 2018

Am J Crit Care

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Background Approximately half of hospital-acquired pressure injuries identified among critical care patients are stage 1. Although stage 1 injuries are common, outcomes associated with them among critical care patients have not been examined. Objectives To examine the outcomes of stage 1 pressure injuries among critical care patients and to identify factors associated with worsening of pressure injuries. Methods Electronic health records were used to determine which surgical critical care patients at a level I trauma center and academic medical center had stage 1 pressure injuries. Competing risk survival analysis was used to identify factors associated with worsening of pressure injuries. Results Review of 6377 patient records indicated that 259 patients (4.1%) experienced stage 1 injuries. The injuries persisted until discharge from the hospital in 92 patients (35.5%), worsened into injuries of stage 2 or greater in 84 (32.4%), and healed in 83 (32.0%). Patients whose pressure injuries worsened were more likely to be older (subdistribution hazard ratio [SHR], 1.02; 95% CI, 1.01–1.03; P = .002), or to have higher levels of serum lactate (SHR, 1.06; 95% CI, 1.02–1.10; P = .007), lower levels of hemoglobin (SHR, 0.82; 95% CI, 0.71–0.96; P = .01), or decreased oxygen saturation by pulse oximetry(< 90%; SHR, 1.50; 95% CI, 1.00–2.25; P = .05). Conclusions Stage 1 pressure injuries worsen in about one-third of patients (32.4%). Nurses should consider maximal treatment for patients who are older or who experience alterations in oxygen delivery or perfusion. (American Journal of Critical Care. 2018; 27:471–476)

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Section: Discussionmentioning

confidence: 99%

Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study

Alderden¹,

Zhao²,

Zhang³

et al. 2018

Am J Crit Care

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“…Currently, the Braden scale is used for the assessment of patients with physical handicaps [39], in traumatology [40], paediatrics [41], and palliative home care [42]. Lima-Serrano et al state that the Braden scale has a specificity of 64% and a sensitivity of 83% [43]. These percentages are greater than those stated by S atekov a et al who state specificity of 50% and a sensitivity of 70.09% for the Czech population [14], and a specificity of 53.48% and a sensitivity of 85.71% for the Slovak population [32].…”

Section: Pressure Ulcer Risk Assessment With the Braden Scalementioning

confidence: 99%

Assessment of pressure ulcers in physically handicapped patients

Neugebauer

Tóthová

2020

DHS

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PurposeAssessment of pressure ulcers is an indicator of nursing care quality. In physically handicapped patients, the risk is elevated, due to the neuropathy and incontinence that frequently accompany paresis and paralysis. We conducted a systematic review of 4 assessment scales to assess their use and usefulness for these patients.Materials/methodsWe searched 5 databases for articles published between 2016 and 2018 that included terms related to the risk of pressure ulcers in physically handicapped patients, including the names of 4 assessment scales (Norton, Braden, Waterlow and Spinal Cord Injury Pressure Ulcer Scale). One hundred and three sources were returned, from which we selected 10. We also selected an earlier source, for a total of 11.ResultsThe Braden and Waterlow scales are popular in clinical practice. The Norton scale is used for scientific comparisons and in clinical practice only sporadically. Expert opinion suggests that acceptance of the Spinal Cord Injury Pressure Ulcer Scale could reduce the incidence of pressure ulcers in physically handicapped patients.ConclusionsIntroduction of a scale designed for handicapped patients, combined with better preventive measures, could result in the bedsore reduction of pressure ulcers. Research testing the effectiveness of the Spinal Cord Injury Pressure Ulcer Scale in the Czech population is needed to validate its use in clinical practice.

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“…Because these patients have more complicated comorbid diseases, unstable hemodynamic, increased tissue pressure, or failure to respond to the tissue pressure properly as a consequence of sedation, analgesia, having mechanical ventilator, bedridden for long times, and/or the use of muscle relaxants [ 2 , 3 ]. The incidence varied from 3.3% to 59.4% depending on study design [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. For example, the incidence of patients who developed PUs in an adult ICU of a general third-level hospital, Spain in 2015 was 8.1% (grade I and II pressure ulcer was 40.6% and 59.4%, respectively) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence varied from 3.3% to 59.4% depending on study design [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. For example, the incidence of patients who developed PUs in an adult ICU of a general third-level hospital, Spain in 2015 was 8.1% (grade I and II pressure ulcer was 40.6% and 59.4%, respectively) [ 3 ]. An incidence of 31% was found from a study in Italy (2000–2010) [ 4 ] and 25.6% from a study in Iran (2011–2012) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…One study in surgical ICU in the US (2005–2008) reported the incidence of PUs of 23.9% [ 6 ] and one study in a 1200-bed university hospital in China (2012) was 31.4% [ 8 ]. Patients with PUs are at greater risk to have several adverse health outcomes which are increased morbidity, mortality and poorer quality of life [ 3 , 11 ]. Although not all PUs are preventable [ 12 , 13 ], active prevention remains crucial in lessening the occurrence of the PUs.…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of CAVE score in predicting presence of pressure ulcer in intensive care patients

Ninbanphot

Narawong

Theeranut

et al. 2020

Heliyon

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Background Pressure ulcers (PUs) are one of the quality care indicators in nursing care. They are considered to primarily be preventable. Early identification of the patients most at risk particular for critically ill patients is crucial for providing prompt care. Several tools have been developed to support healthcare providers, but their validities are limited in Thailand. Development of tools with better performance is essential. Aims To develop and validate a PU risk assessment tool with good diagnostic properties in intensive care units (ICUs). Methods A prospective study was conducted in ICUs of a tertiary care hospital, Thailand from January 2019 to April 2020. Baseline data were collected at admission to the ICUs. Skin assessment was evaluated every 24 h. Data were divided into two sets: model development and model validation. Creating a risk score which was derived from multivariate methods were performed. Youden index were used to determine the optimal cut-off point. Then, the other dataset was used to validate the risk score. Receiver Operating Characteristic (ROC) curves was used to demonstrate the performance of the test. Results The study included 288 and 270 patients for development and validation models. The risk score consisted 4 clinical factors; presence of Cardiovascular disease, low serum Albumin, having Ventilated, and Edema (CAVE score). The area under the ROC curve (AUC) was 0.8 and a score at 2.5 was the best cut-off point. The AUC in the validation group was 0.6, age<60 years was 0.78, and age≥60 years was 0.57. Conclusion The predictive validity of the CAVE score is limited but comparable to the existing tools in Thailand. However, it has a good diagnostic property in young patients. The CAVE score could be considered as an alternate screening tool in critical care setting particularly for young patients.

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Validez predictiva y fiabilidad de la escala de Braden para valoración del riesgo de úlceras por presión en una unidad de cuidados intensivos

Cited by 26 publications

References 22 publications

Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study

Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study

Assessment of pressure ulcers in physically handicapped patients

Development and validation of CAVE score in predicting presence of pressure ulcer in intensive care patients

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