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Meta-Analysis
. 2020 May;25(3):165-170.
doi: 10.1111/nicc.12500. Epub 2020 Jan 27.

Predictive Validity of the Braden Scale for Pressure Ulcer Risk in Critical Care: A Meta-Analysis

Min Wei  1 , Ling Wu  2 , Yan Chen  3 , Qiaomei Fu  4 , Wenyue Chen  1 , Dongliang Yang  5
Affiliations
Meta-Analysis

Predictive Validity of the Braden Scale for Pressure Ulcer Risk in Critical Care: A Meta-Analysis

Min Wei et al. Nurs Crit Care. 2020 May.

Abstract

Background: Pressure ulcers (PUs) are encountered in all types of care settings. The incidence of PUs in the intensive care unit (ICU) is higher for a variety of reasons. The Braden Scale is a widely used tool to assess the risk of PU, but its predictive power is controversial in ICU settings. In this systematic review and meta-analysis, we aimed to evaluate the predictive accuracy of the Braden Scale for measurement of risk of PU in adult ICU patients.

Methods: A comprehensive literature search in English databases (PubMed, Cochrane Library, OVID, and Web of Science), Chinese databases (SinoMed, CNKI, and Wanfang), and gray literature was performed. Studies assessing the predictive value of the Braden Scale for risk of PU in adult ICU patients were searched. Quality of the studies was scored with Quality Assessment of Diagnostic Accuracy Studies-2. Country, study design, setting, blinding, and characteristics of included studies were extracted.

Results: Eleven full-text articles containing 10 044 patients, comprising 1058 patients with PUs were included. The pooled sensitivity and specificity of the Braden Scale for predicting PU risk in ICU adults were 0.89 (95% CI, 0.87-0.91; I2 = 94.9%, P = .0000) and 0.28 (95% CI, 0.27-0.29; I2 = 99.2%, P = .0000), respectively. The pooled DOR was 6.29 (95% CI: 4.09-9.68). The overall weighted AUC was 0.7812 ± 0.0331 (95% CI: 0.7163-0.8461) and the Q* value was 0.7196 ± 0.0283 (95% CI: 0.6641-0.7751). Significant heterogeneity was noted among the included studies. Meta-regression analysis showed that there was no heterogeneity in blinding (P = .074), study design (P = .679), or cut-off value (P = .821).

Conclusions: This meta-analysis demonstrated that the Braden Scale had a moderate predictive validity with good sensitivity and low specificity in adult critically ill patients. Further development and modification of this tool or generation of a new tool with higher predictive power is warranted for use in ICU populations.

Relevance to clinical practice: The first step in prevention of PU is risk assessment. In this meta-analysis, we aimed to evaluate the predictive power of the Braden Scale for assessing risk of PU in ICU adult patients, which could potentially guide clinical practice.

Keywords: intensive care unit; meta-analysis; pressure ulcer; risk; validity.

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References

REFERENCES

    1. Ahtiala M, Laitio R, Soppi E. Therapeutic hypothermia and pressure ulcer risk in critically ill intensive care patients: a retrospective study. Intensive Crit Care Nurs. 2018;46:80-85.
    1. Igarashi A, Yamamoto-Mitani N, Gushiken Y, Takai Y, Tanaka M, Okamoto Y. Prevalence and incidence of pressure ulcers in Japanese long-term care hospitals. Arch Gerontol Geriatr. 2013;56:220-226.
    1. Moon M. The characteristics related to the development of pressure ulcers in long term care facilities: the use of 2009 National Patient Sample. J Korea Acad-Ind Coop Soc. 2013;14:3390-3399. (in Korean).
    1. Borghardt AT, Prado TN, Araujo TM, Rogenski NM, Bringuente ME. Evaluation of the pressure ulcers risk scales with critically ill patients: a prospective cohort study. Rev Lat Am Enfermagem. 2015;23:28-35.
    1. Cox J. Predictive power of the Braden scale for pressure sore risk in adult critical care patients: a comprehensive review. J Wound Ostomy Continence Nurs. 2012;39:613-621.

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