Comparison of three pressure injury assessment scales for predicting pressure injury in patients after cardiopulmonary bypass in ICU#br#
LI Zhengang1 WANG Yating2 QI Jinfang3 DONG Zhenghui4
1.Department of Critical Care Medicine, Xinjiang Medical University Affiliated First Hospital, Xinjiang Uygur Autonomous Region, Urumqi 830092, China; 2.Vocational and Technical School, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Kuerle 841000, China;
3.Nursing School, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830092, China;
4.Department of Nursing, Xinjiang Medical University Affiliated Sixth Hospital, Xinjiang Uygur Autonomous Region, Urumqi 830092, China
Abstract Objective To compare the predictive effects of Braden, COMHON, Cubbin & Jackson scales on pressure injury in intensive care unit (ICU) patients after cardiopulmonary bypass, and to screen the best predictive tool for pressure injury risk in such patients. Methods The Braden scale, COMHON scale, and Cubbin & Jackson scale were used to assess the risk of pressure injury in 252 patients admitted to a tertiary hospital after cardiopulmonary bypass from September 2017 to February 2019. The predictive power of the three scales for pressure injury occurring within seven days was compared. Results Among 252 ICU patients after cardiopulmonary bypass, 150 patients developed pressure injury within seven days, and 102 patients did not develop pressure injury. There were significant differences in disease type, acute physiology and chronic health evaluationⅡ score and mechanical ventilation time between the two groups (P ＜ 0.05). Comparison of the predictive ability of the three scales: the Braden scale for predicting the occurrence of pressure injury in patients after cardiopulmonary bypass in the ICU with a critical value of 10 points, the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and positive likelihood ratio, the negative likelihood ratios were 0.512, 29.33%, 74.51%, 1.149, 0.948, and 0.523; the critical value of COMHON scale for predicting the occurrence of pressure injury in patients after cardiopulmonary bypass in ICU was 17 points, and its AUC, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 0.523, 30.67%, 80.39%, 1.564, 0.862, respectively; the critical value of the Cubbin & Jackson scale for predicting the occurrence of pressure injury in patients after cardiopulmonary bypass in the ICU was 25 points, and its AUC, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 0.687, 64.67%, 64.71%, 1.837, 0.546. There was a statistically significant difference in the scores of inotropic drugs between the two groups (P ＜ 0.05). Conclusion The Cubbin & Jackson scale in more suitable than the Braden scale and the COMHON scale to predict pressure injury in patients after cardiopulmonary bypass in the ICU.
LI Zhengang1 WANG Yating2 QI Jinfang3 DONG Zhenghui4. Comparison of three pressure injury assessment scales for predicting pressure injury in patients after cardiopulmonary bypass in ICU#br#[J]. 中国医药导报, 2022, 19(9): 50-54.
[1] Edsberg LE，Black JM，Goldberg M，et al. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System：Revised Pressure Injury Staging System [J]. J Wound Ostomy Continence Nurs，2016，43（6）：585-597.
[2] Lima Serrano M，González Méndez MI，Carrasco Cebollero FM，et al. Risk factors for pressure ulcer development in Intensive Care Units：A systematic review [J]. Med Intensiva，2017，41（6）：339-346.
[3] Coyer F，Miles S，Gosley S，et al. Pressure injury prevalence in intensive care versus non-intensive care patients：A state-wide comparison [J]. Aust Crit Care，2017， 30（5）：244-250.
[4] Manzano F，Navarro MJ，Roldán D，et al. Pressure ulcer incidence and risk factors in ventilated intensive care patients [J]. 2010，25（3）：469-476.
[5] Rao AD，Preston AM，Strauss R，et al. Risk Factors Associated With Pressure Ulcer Formation in Critically Ill Cardiac Surgery Patients：A Systematic Review [J]. J Wound Ostomy Continence Nurs，2016，43（3）：242-247.
[6] Hatanaka N，Yamamoto Y，Ichihara K，et al. A new predictive indicator for development of pressure ulcers in bedridden patients based on common laboratory tests results [J]. J Clin Pathol，2008，61（4）：514-518.
[7] Adibelli S，Korkmaz F. Pressure injury risk assessment in intensive care units：Comparison of the reliability and predictive validity of the Braden and Jackson/Cubbin scales [J]. J Clin Nurs，2019，28（23/24）：4595-4605.
[8] Riccioni N，Berlanga R，Hagan J，et al. Interrater Reliability of the Braden and Braden Q by Skin Champion Nurses [J]. J Pediatr Nurs，2019，44：9-15.
[9] Wei M，Wu L，Chen Y，et al. Predictive Validity of the Braden Scale for Pressure Ulcer Risk in Critical Care：A Meta-Analysis [J]. Nurs Crit Care，2020，25（3）：165-170.
[10] Fulbrook P，Anderson A. Pressure injury risk assessment in intensive care：comparison of inter-rater reliability of the COMHON （Conscious level，Mobility，Haemodynamics，Oxygenation，Nutrition） Index with three scales [J]. J Adv Nurs，2016，72（3）：680-692.
[11] Theeranut A，Ninbanphot S，Limpawattana P. Comparison of four pressure ulcer risk assessment tools in critically ill patients [J]. Nurs Crit Care，2021，26（1）：48-54.
[12] Compton F，Strauss M，Hortig T，et al. Validity of the Waterlow scale for pressure ulcer risk assessment in the intensive care unit：a prospective analysis of 698 patients [J]. Pflege，2008，21（1）：37-48.
[13] Kottner J，Dassen T. Pressure ulcer risk assessment in critical care：interrater reliability and validity studies of the Braden and Waterlow scales and subjective ratings in two intensive care units [J]. Int J Nurs Stud，2010，47（6）：671-677.
[14] Ranzani OT，Simpson ES，Japiassú AM，et al. The Challenge of Predicting Pressure Ulcers in Critically Ill Patients. A Multicenter Cohort Study [J]. Ann Am Thorac Soc，2016，13（10）：1775-1783.
[15] Feuchtinger J，Halfens RJ，Dassen T. Pressure ulcer risk factors in cardiac surgery：a review of the research literature [J]. Heart Lung，2005，34（6）：375-385.
[16] Wang LH，Chen HL，Yan HY，et al. Inter-rater reliability of three most commonly used pressure ulcer risk assessment scales in clinical practice [J]. Int Wound J，2015， 12（5）：590-594.
[17] Leal-Felipe ML?譧，Arroyo-López MDC，Robayna-Delgado MDC，et al. Predictive ability of the EVARUCI scale and COMHON index for pressure injury risk in critically ill patients：A diagnostic accuracy study [J]. Aust Crit Care，2018，31（6）：355-361.
[18] Cox J，Roche S. Vasopressors and development of pressure ulcers in adult critical care patients [J]. Am J Crit Care，2015，24（6）：501-510.
[19] García-Fernández FP，Pancorbo-Hidalgo PL，Agreda JJ. Predictive capacity of risk assessment scales and clinical judgment for pressure ulcers：a meta-analysis [J]. J Wound Ostomy Continence Nurs，2014，41（1）：24-34.
[20] Higgins J，Casey S，Taylor E，et al. Comparing the Braden and Jackson/Cubbin Pressure Injury Risk Scales in Trauma-Surgery ICU Patients [J]. Crit Care Nurse，2020， 40（6）：52-61.
[21] Kim E，Choi M，Lee J，et al. Reusability of EMR Data for Applying Cubbin and Jackson Pressure Ulcer Risk Assessment Scale in Critical Care Patients [J]. Healthc Inform Res，2013，19（4）：261-270.
[22] 姚秀英，徐栩，陈霞，等.汉化版Cubbin & Jackson量表与Braden量表在ICU压疮风险评估中的应用比较[J].护理学杂志，2017，32（6）：44-46.
[23] Bly D，Schallom M，Sona C，et al. A Model of Pressure，Oxygenation，and Perfusion Risk Factors for Pressure Ulcers in the Intensive Care Unit [J]. Am J Crit Care，2016，25（2）：156-164.
[24] Soodmand M，Moghadamnia MT，Aghaei I，et al Effects of Hemodynamic Factors and Oxygenation on the Incidence of Pressure Ulcers in the ICU [J]. Adv Skin Wound Care，2019，32（8）：359-364.
[25] Cox J. Pressure Injury Risk Factors in Adult Critical Care Patients：A Review of the Literature [J]. Ostomy Wound Manage，2017，63（11）：30-43.
[26] Kumta N，Coyer F，David M. Perioperative factors and pressure ulcer development in postoperative ICU patients：a retrospective review [J]. J Wound Care，2018，27（8）：475-485.
