Pressure ulcers risk assessment scales in ICU patients Validity comparison of Jackson/Cubbin (revised) and Braden scales

The pressure ulcers risk assessment scales are very useful as tool to determine required preventive measures. AIM The comparison of predictive validity between Jackson/Cubbin (revised) and Braden scales in an intensive care setting of a general hospital. MATERIAL-METHOD During the 1-year period of the study, 71 patients were recorded. All patients received the same nursing preventive interventions. The followup for ulcer appearance (stage II or superior) was daily while the evaluation and recording of data of two scales became each three days. In the present study the data used, of the above two scaales, was collected in three different times: at the time of admission (Τ1), 72 hours afterwards the admission (T2) and at the time of ulcer presence (Τ3). The statistical analysis included calculation of validity indicators by the Receiver Operating Characteristics analysis (ROC). RESULTS There wasn’t statistical difference between the above three different times Τ1, Τ2 and Τ3 either for Braden (P≥0.1) or for Jackson/Cubbin (P≥0.2). The comparison became with the data of scales at time T3 which gave also the optimal results of validity. Based on the cut-off point of the two scales which are calculated by the analysis (Braden=14, Jackson/Cubbin=34), the indicators for Braden and Jackson/Cubbin respectively were: sensitivity (Se): 87.5%, 100%, specificity (Sp): 40.4%, 46.8%, positive predictive value (PPV): 42.9%, 49% and negative predictive value (NPV): 86.4%, 100%. The area under curve (AUC) was 0.633 for Braden and 0.766 for Jackson/Cubbin. CONCLUSIONS In this study was found that the scale Jackson/Cubbin is more valid than Braden scale for application in critical ill patients. Therefore the ICU nurses should use pressure ulcer risk assessment scales as Jackson/Cubbin, adapting the cut of point in their patient groups. Being able to predict which patients are at risk for pressure ulcers can assist nurses in tailoring care to prevent unnecessary complications, as well as reduce costs and workload.

Category: Volume 47, N 1
Hits: 557 Hits
Created Date: 15-03-2008
Authors: Dimitrios Kosmidis , Sotiria Koutsouki