Predictive Power of the Braden Scale for Pressure Sore Risk in Adult Critical Care Patients

2012 ◽  
Vol 39 (6) ◽  
pp. 613-621 ◽  
Author(s):  
Jill Cox
Keyword(s):  
Critical Care ◽  
Predictive Power ◽  
Pressure Sore ◽  
Braden Scale ◽  
Critical Care Patients

scholarly journals Predictive validity of the Braden scale for pressure ulcer risk in critical care patients

2011 ◽  
Vol 19 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Letícia Faria Serpa ◽  
Vera Lúcia Conceição de Gouveia Santos ◽  
Ticiane Carolina Gonçalves Faustino Campanili ◽  
Moelisa Queiroz
Keyword(s):  
Critical Care ◽  
Predictive Validity ◽  
Private Hospital ◽  
Good Accuracy ◽  
Predictive Performance ◽  
Roc Curves ◽  
Methodological Study ◽  
Braden Scale ◽  
Hospital Ethics ◽  
Critical Care Patients

This methodological study aimed to evaluate the predictive validity of the Braden scale in critical care patients. The study was conducted in four intensive care units of a general private hospital. After approval of the project by the Hospital Ethics Committee, during six months, adult patients admitted to ICUs with a Braden score <18 and without PU were assessed upon admission and at 48-hours intervals as long as the patient remained at risk or until the development of PU, patients' discharge, death or transfer from the ICU. The cut-off scores of the Braden scale in the first, second and third assessments were 12, 13 and 13, respectively. Sensitivity was 85.7%, 71.4% and 71.4% and specificity was 64.6%, 81.5% and 83.1%, respectively. Areas under the ROC curves revealed very good accuracy for the cut-off scores. The Braden cut-off score 13 in the third assessment showed the best predictive performance in critical care patients.

Identifying Risk Factors for Pressure Injury in Adult Critical Care Patients

2020 ◽  
Vol 29 (3) ◽  
pp. 204-213 ◽  
Author(s):  
Jill Cox ◽  
Marilyn Schallom ◽  
Christy Jung
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Critical Care ◽  
Intensive Care ◽  
Decision Tree ◽  
Scale Score ◽  
Critically Ill Patients ◽  
Braden Scale ◽  
Pressure Injury ◽  
Critical Care Patients

Background Critically ill patients have a variety of unique risk factors for pressure injury. Identification of these risk factors is essential to prevent pressure injury in this population. Objective To identify factors predicting the development of pressure injury in critical care patients using a large data set from the PhysioNet MIMIC-III (Medical Information Mart for Intensive Care) clinical database. Methods Data for 1460 patients were extracted from the database. Variables that were significant in bivariate analyses were used in a final logistic regression model. A final set of significant variables from the logistic regression was used to develop a decision tree model. Results In regression analysis, cardiovascular disease, peripheral vascular disease, pneumonia or influenza, cardiovascular surgery, hemodialysis, norepinephrine administration, hypotension, septic shock, moderate to severe malnutrition, sex, age, and Braden Scale score on admission to the intensive care unit were all predictive of pressure injury. Decision tree analysis revealed that patients who received norepinephrine, were older than 65 years, had a length of stay of 10 days or less, and had a Braden Scale score of 15 or less had a 63.6% risk of pressure injury. Conclusion Determining pressure injury risk in critically ill patients is complex and challenging. One common pathophysiological factor is impaired tissue oxygenation and perfusion, which may be nonmodifiable. Improved risk quantification is needed and may be realized in the near future by leveraging the clinical information available in the electronic medical record through the power of predictive analytics.

scholarly journals Predicting the Risk for Hospital-Acquired Pressure Ulcers in Critical Care Patients

2017 ◽  
Vol 37 (4) ◽  
pp. e1-e11 ◽  
Author(s):  
Xiaohong Deng ◽  
Ting Yu ◽  
Ailing Hu
Keyword(s):  
Logistic Regression ◽  
Critical Care ◽  
Intensive Care ◽  
Decision Tree ◽  
Pressure Ulcers ◽  
Prediction Models ◽  
Risk Prediction Models ◽  
Braden Scale ◽  
Hospital Acquired ◽  
Critical Care Patients

BACKGROUND Assessments of risk for pressure ulcers in critical care patients may not include important predictors. OBJECTIVE To construct risk-prediction models of hospital-acquired pressure ulcers in intensive care patients and compare the models’ predictive validities with validity of the Braden Scale. METHODS Data were collected retrospectively on patients admitted to intensive care from October 2011 through October 2013. Logistic regression and decision trees were used to construct the risk-prediction models. Predictive validity was measured by using sensitivity, specificity, positive and negative predictive values, and area under the curve. RESULTS With logistic regression analysis, 6 factors were significant independent predictors. With the decision tree, 4 types of high-risk populations were identified. Predictive validity of Braden Scale scores was lower than the validities of the logistic regression and the decision tree models. CONCLUSION Risk for hospital-acquired pressure ulcers is overpredicted with the Braden Scale, with low specificity and low positive predictive value

Comparing the Braden and Jackson/Cubbin Pressure Injury Risk Scales in Trauma-Surgery ICU Patients

2020 ◽  
Vol 40 (6) ◽  
pp. 52-61
Author(s):  
Jacob Higgins ◽  
Sherri Casey ◽  
Erin Taylor ◽  
Riley Wilson ◽  
Paula Halcomb
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Predictive Value ◽  
Injury Risk ◽  
Area Under The Curve ◽  
Surgical Patients ◽  
Braden Scale ◽  
Surgical Critical Care ◽  
Pressure Injury ◽  
Critical Care Patients

Background The occurrence of pressure injury in the critical care environment has multiple risk factors. Prevention requires reliable assessment tools to help predict injury risk. The Braden scale, a commonly used risk assessment tool, has been shown to have poor predictive properties in critical care patients. The Jackson/Cubbin scale was developed specifically for pressure injury risk stratification in critically ill patients and has demonstrated acceptable predictive properties in the general critical care population but has not been examined in critically ill trauma-surgical patients. Objective To compare the predictive properties of the Braden and Jackson/Cubbin scales in a trauma-surgical critical care population. Methods A retrospective medical records review was performed to evaluate the clinical characteristics of 366 trauma-surgical critical care patients. Additionally, the negative predictive value, positive predictive value, sensitivity, specificity, and receiver operating characteristic curve with area under the curve of the Braden and Jackson/Cubbin scales were determined. Results The sample consisted of primarily middle-aged (mean [SD], 56 [19] years) men (64%) admitted after trauma (71%). The participants who developed pressure injuries were older, more often required vasopressors and mechanical ventilation, and were less mobile. Predictive properties for the Braden and Jackson/Cubbin scales, respectively, were as follows: negative predictive value, 78% versus 87%; positive predictive value, 53% versus 66%; sensitivity, 17% versus 54%; specificity, 95% versus 92%; and area under the curve, 0.710 versus 0.793. Conclusion The Jackson/Cubbin scale demonstrated superior predictive properties and discrimination compared with the Braden scale for pressure injury risk prediction in critically ill trauma-surgical patients.

Risk Factors for Hospital-Acquired Pressure Injury in Adult Critical Care Patients

2022 ◽  
Vol 31 (1) ◽  
pp. 42-50
Author(s):  
Phillip Kim ◽  
Vamsi K. Aribindi ◽  
Amy M. Shui ◽  
Sharvari S. Deshpande ◽  
Sachin Rangarajan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Critical Care ◽  
Scale Score ◽  
Arterial Oxygen ◽  
Effective Prevention ◽  
Braden Scale ◽  
Pressure Injury ◽  
Hospital Acquired ◽  
Critical Care Patients

Background Accurately measuring the risk of pressure injury remains the most important step for effective prevention and intervention. Relative contributions of risk factors for the incidence of pressure injury in adult critical care patients are not well understood. Objective To develop and validate a model to identify risk factors associated with hospital-acquired pressure injuries among adult critical care patients. Methods This retrospective cohort study included 23 806 adult patients (28 480 encounters) with an intensive care unit stay at an academic quaternary care center. Patient encounters were randomly split (7:3) into training and validation sets. The training set was used to develop a multivariable logistic regression model using the least absolute shrinkage and selection operator method. The model’s performance was evaluated with the validation set. Results Independent risk factors identified by logistic regression were length of hospital stay, preexisting diabetes, preexisting renal failure, maximum arterial carbon dioxide pressure, minimum arterial oxygen pressure, hypotension, gastrointestinal bleeding, cellulitis, and minimum Braden Scale score of 14 or less. On validation, the model differentiated between patients with and without pressure injury, with area under the receiver operating characteristic curve of 0.85, and performed better than a model with Braden Scale score alone (P &lt; .001). Conclusions A model that identified risk factors for hospital-acquired pressure injury among adult critical care patients was developed and validated using a large data set of clinical variables. This model may aid in selecting high-risk patients for focused interventions to prevent formation of hospital-acquired pressure injuries.

scholarly journals The pathophysiology of “happy” hypoglycemia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Thomas Loeb ◽  
Anna Ozguler ◽  
Geraldine Baer ◽  
Michel Baer
Keyword(s):  
Critical Care ◽  
Hemorrhagic Shock ◽  
Lactate Production ◽  
Severe Hypoglycemia ◽  
Altered Mental Status ◽  
Case Presentation ◽  
Energy Substrate ◽  
Tissue Hypoperfusion ◽  
The Brain ◽  
Critical Care Patients

Abstract Background Hypoglycemia usually includes various neurological symptoms, which are the consequence of neuroglycopenia. When it is severe, it is associated with altered mental status, even coma. Case presentation We report the case of a patient with severe hypoglycemia, completely asymptomatic, due to the increase of lactate production in response to tissue hypoperfusion following a hemorrhagic shock. This illustrates that lactate can substitute glucose as an energy substrate for the brain. It is also a reminder that this metabolite, despite its bad reputation maintained by its role as a marker of severity in critical care patients, has a fundamental role in our metabolism. Conclusions Following the example of the “happy hypoxemia” recently reported in the literature describing asymptomatic hypoxemia in COVID-19 patients, we describe a case of “happy hypoglycemia.”

scholarly journals Improving glycemic control in critical care patients

2008 ◽  
Vol 3 (4) ◽  
pp. 30-35
Author(s):  
Julie L. Stone ◽  
Linda L. Hutchinson
Keyword(s):  
Critical Care ◽  
Glycemic Control ◽  
Critical Care Patients
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