J Korean Crit Care Nurs.  2019 Jun;12(2):26-38. 10.34250/jkccn.2019.12.2.26.

Predictive Validity of Pressure Ulcer Risk Assessment Scales among Patients in a Trauma Intensive Care Unit

• Choi JE
• Hwang SK

• KMID: 2451929
• DOI: http://doi.org/10.34250/jkccn.2019.12.2.26

Abstract

PURPOSE
The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients.
METHODS
This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC).
RESULTS
Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson).
CONCLUSION
The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

Keyword

Pressure ulcer; Risk assessment; Validity; Trauma; Intensive care unit

MeSH Terms

Area Under Curve
Critical Care*
Humans
Incidence
Intensive Care Units*
Observational Study
Pressure Ulcer*
Prospective Studies
Risk Assessment*
ROC Curve
Sensitivity and Specificity
Weights and Measures*