Midrange Braden Subscale Scores Are Associated With Increased Risk for Pressure Injury Development Among Critical Care Patients.
Midrange Braden Subscale Scores Are Associated With Increased Risk for Pressure Injury Development Among Critical Care Patients.
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DOI：
10.1097/won.0000000000000349
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Thomas D
中科院分区：
文献类型：
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作者：
Alderden J;Cummins MR;Pepper GA;Whitney JD;Zhang Y;Butcher R;Thomas D
本研究的目的是检查外科ICU人群中压力损伤发展与Braden量表压疮风险子量表评分之间的关系，并确定子量表评分所代表的风险在老年患者与年轻患者之间是否存在差异。我们通过电子健康记录数据确定了6377例外科ICU患者的队列，以确定Braden量表总分和子量表评分、年龄和压力损伤发生率。我们使用生存分析来确定与Braden量表的每个子量表相关的压力损伤的危险，以最低风险类别作为参考。此外，我们使用自然三次样条的时间依赖性考克斯回归来模拟年龄与Braden量表评分和压力损伤风险子量表评分之间的相互作用。在6377例ICU患者中，214例（4%）发生了压力损伤（2-4期，深部组织损伤或无法分期），516例（8%）发生了任何阶段的医院获得性压力损伤。除摩擦和剪切分量表外，无论年龄大小，得分处于中等风险水平的个体发生压力损伤的可能性最高。年龄、Braden量表子量表评分和压力损伤发展之间的关系在子量表中各不相同。最大的预防工作应扩大到包括个人中间Braden量表评分，年龄应考虑沿着作为一个因素，在护理计划的子量表评分。
The purpose of the current study was to examine the relationship between pressure injury development and Braden Scale for Pressure Sore Risk subscale scores in a surgical ICU population, and to ascertain whether the risk represented by the subscale scores is different between older versus younger patients. We identified a cohort of 6377 surgical ICU patients via electronic health record data to determine Braden Scale total and subscale scores, age, and incidence of pressure injury development. We used survival analysis to determine the hazards of developing a pressure injury associated with each subscale of the Braden Scale, with the lowest risk category as a reference. In addition, we used time-dependent Cox regression with natural cubic splines to model the interaction between age and Braden Scale scores and subscale scores in pressure injury risk. Of the 6377 ICU patients, 214 (4%) developed a pressure injury (Stages 2–4, deep tissue injury, or unstageable) and 516 (8%) developed a hospital-acquired pressure injury of any stage. With the exception of the friction and shear subscales, regardless of age, individuals with scores in the intermediate risk levels had the highest likelihood of developing pressure injury. The relationship between age, Braden Scale subscale scores, and pressure injury development varied among subscales. Maximal preventive efforts should be extended to include individuals with intermediate Braden Scale subscale scores, and age should be considered along with the subscale scores as a factor in care planning.