A review of scales for assessing the risk of developing a pressure ulcer in individuals with SCI

Mortenson, W. Ben; Miller, William C.

doi:10.1038/sj.sc.3102129

Cited by 55 publications

(39 citation statements)

References 30 publications

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“…The BRDs cover only part of these risk factors and is thus considered to be inadequate in the full risk assessment. Risk assessment scales that contain the other parameters and that are more suitable for the patients of our country are required, or the existing scales need serious modifications (29,31,(44)(45)(46)(47)(48)(49). Pressure ulcer development risk in patients treated in ICUs should be revised in coordination with healthcare workers.…”

Section: Resultsmentioning

confidence: 99%

Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients?

Gül¹,

Köprülü²,

Haspolat³

et al. 2016

JAREM

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Objective: To prevent pressure ulcer, detecting risk factors and planning how to act with respect to patients provide to find solution. Thus, Braden Scale is the most common tool that is used in Turkey. This study aimed to measure Braden Scale effectiveness at detecting the risk groups of level 3 intensive care unit patients.Methods: This prospective, single-center study includes 206 level 3 intensive care unit patients whose risk factors were standardized as much as possible in the intensive care unit between January 2014 and May 2015. Routine clinical care was applied to the patients whose risk groups were determined by Braden Scale, and the patients were divided into two groups depending on the presence of a pressure ulcer before discharging from the hospital. Demographic findings, hospitalization duration, mental status, Apache II score, expected/actual mortality, blood albumin levels, and Braden Scale score were compared. Results:Comparison of the groups showed that patients' age, length of stay in intensive care unit, mental status, and blood albumin levels are significantly different between patients with and without pressure ulcers. Furthermore, scores of patients with pressure ulcers were not significantly different from those of patients without pressure ulcers. Data also illustrated that pressure ulcers occurred in no risk patients with the ratio of 7.14%; in low-risk patients with the ratio of 27.8%; in moderate-risk patients with the ratio of 29.73%; in high-risk patients with the ratio of 17.72%.Conclusion: Data evaluation demonstrates that Braden Scale is not effective to detect the risk factors, and parameters related to pressure ulcer development are not sufficiently represented by Braden Scale. Modification of an existing scale or a new risk assessment scale that includes all other risk parameters and that is more suitable for the patients of our country is required. (JAREM 2016; 6: 98-104)

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Section: Resultsmentioning

confidence: 99%

Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients?

Gül¹,

Köprülü²,

Haspolat³

et al. 2016

JAREM

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“…Since their original publication, the metrological values of these two scales have not been sufficiently tested to set clinical practice recommendations. 13 Furthermore, an independent study reports no significant differences between SCIPUS-A, Braden, Norton and Waterlow scales for acute SCI. 14 Since then, new epidemiological studies focusing on patients with SCI have brought up new additional risk factors 15 that can probably explain the lack of validity…”

Section: Introductionmentioning

confidence: 97%

Pressure ulcer risk factors in persons with SCI: part I: acute and rehabilitation stages

Gélis

Dupeyron

Legros³

et al. 2008

Spinal Cord

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Background: Pressure ulcers (PUs) are a common complication following a spinal-cord injury (SCI). Good prevention requires identifying the individuals at risk for developing PUs. Risk assessment scales used nowadays were designed on pathophysiological concepts and are not SCI-specific. Recently, an epidemiological approach to PU risk factors has been proposed to design an SCI-specific assessment tool. The first results seem quite disappointing, probably becuase of the level of evidence of the risk factors used. Objective: To determine PU risk factors correlated to the patients with SCI, medical care management during the acute as well as in the rehabilitation and chronic stages. This first part focuses on identifying the risk factors during the acute and rehabilitation stages. Materials and methods: Systematic review of the literature. Results: Six studies met our inclusion criteria. The risk factors during the acute stage of an SCI are essentially linked to care management and treatment modalities. There is insufficient evidence to make a recommendation on medical risk factors, except for low blood pressure on admission to the Emergency Room, with a moderate level of evidence. Regarding the rehabilitation stage, no study was deemed relevant. Discussion and conclusions: Additional observational studies are needed, for both the acute and rehabilitation stages, to improve this level of evidence. However, this systematic review unveiled the need for a carefully assessed t care management and the related practices, especially during the acute stage of an SCI.

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“…9 The predictive value of these scales is, however, unclear. 10 A recent review found no studies on risk factors for pressure ulcers during the initial rehabilitation phase in a homogeneous SCI population. 11 Two rehabilitation studies were identified in this review, but both studies included patients in initial rehabilitation as well as re-hospitalized patients.…”

Section: Introductionmentioning

confidence: 99%

Occurrence and predictors of pressure ulcers during primary in-patient spinal cord injury rehabilitation

et al. 2010

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Study design: Multicenter prospective cohort study. Objectives: To determine the occurrence and predictors for pressure ulcers in patients with spinal cord injury (SCI) during primary in-patient rehabilitation. Setting: Eight Dutch rehabilitation centres with specialized SCI units. Methods: The occurrence, location and stage of pressure ulcers were registered between admission and start of functional rehabilitation (called acute rehabilitation phase) and between start of functional rehabilitation and discharge. Possible risk factors for the occurrence of pressure ulcers during functional rehabilitation (personal and lesion characteristics, complications and functional independence) were measured at the start of functional rehabilitation and were entered as predictors in univariate and multivariate logistic regression analysis with pressure ulcers during functional rehabilitation as the dependent variable. Results: Data for 193 patients (86%) were available. The occurrence of pressure ulcers, including stage 1, was 36.5% during acute rehabilitation phase and 39.4% during functional rehabilitation. Most pressure ulcers were located at the sacrum (43%), followed by heel (19%) and ischium (15%). The significant risk factors for pressure ulcers during functional rehabilitation were motor completeness of the lesion, tetraplegia, pressure ulcer during acute rehabilitation phase, pneumonia and/or pulmonary disease, low score on the Functional Independence Measure (FIM) self-care, continence, transfers, locomotion and total FIM motor score. Having had a pressure ulcer during acute rehabilitation phase was the strongest risk factor. Conclusion: The occurrence of pressure ulcers was comparable with other studies. A few significant risk factors were found, of which having had a pressure ulcer during acute rehabilitation phase being the strongest predictor.

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A review of scales for assessing the risk of developing a pressure ulcer in individuals with SCI

Cited by 55 publications

References 30 publications

Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients?

Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients?

Pressure ulcer risk factors in persons with SCI: part I: acute and rehabilitation stages

Occurrence and predictors of pressure ulcers during primary in-patient spinal cord injury rehabilitation

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