Evaluation of the Braden scale in predicting surgical outcomes in older patients undergoing major head and neck surgery

Abstract

Background Being able to predict negative postoperative outcomes is important for helping select patients for treatment as well for informed decision‐making by patients. Frailty measures are often time and resource intensive to use as screening measures, whereas the Braden scale, a commonly used measure to assess patients at risk of developing pressure ulcers after surgery, may be a potential tool to predict postoperative complication rates and longer length of stay (LOS) in patients undergoing major head and neck cancer surgery. Methods A retrospective analysis of Braden scale scores was performed on a prospectively collected cohort of patients undergoing major head and neck surgery recruited between December 2011 and April 2014. The association of Braden scale score with the primary outcomes of complications and LOS was analyzed using logistic regression and linear regression models on univariate analysis (UVA), respectively. Multivariate analysis (MVA) was performed based on a backward stepwise selection algorithm. Results There were 232 patients with a mean (SD) Braden scale score of 14.9 (2.8) with a range from 9 to 23. The Braden scale (β = −.07 per point; 95% CI −0.09, −0.04, P < .001) was an independent predictor of increased LOS on UVA, but not on MVA when adjusted for other variables. For overall complications, as well as type of complication, the Braden scale score was not a significant predictor of complications on either UVA or MVA. Conclusion In the sample population, the Braden scale did not demonstrate an ability to predict negative outcomes in head and neck surgery patients. Level of Evidence Level 2b individual cohort study.

Comparison of four risk assessment scales in predicting the risk of intraoperative acquired pressure injury in adult surgical patients: a prospective study

“…While the Braden scale may not prove to be an effective assessment tool in predicting the risk of IAPI, these results are consistent with the findings of other related studies. 28,29 Different studies have yielded varying results regarding the efficacy of the four risk assessment tools for assessment of the stress injury risk. The Munro scale has been translated into multiple languages, widely popularized, and applied in recent years.…”

“…While the Braden scale may not prove to be an effective assessment tool in predicting the risk of IAPI, these results are consistent with the findings of other related studies. 28 , 29 …”

Validez convergente y discriminativa del índice Frágil-VIG con la escala de Braden en personas atendidas en atención domiciliaria

“…Este hecho ha facilitado la evaluación de su validez predictiva de mortalidad: en procesos médicos (23,24), procesos quirúrgicos (25,26), unidades de cuidados intensivos (27), o más recientemente en hospitalizaciones por COVID-19 (28). Algunos de estos estudios también hallaron validez predictiva de la escala de Braden sobre el aumento de días de estancia hospitalaria (23,24,29).…”

Epidemiological characteristics of pressure injury and the predictive validity of Braden scale among the older hospitalized patients: A cross‐sectional study

“…Although the Braden scale has played an important role in the prevention of PI in countries around the world (Q. Jiang et al, 2020; Källman & Lindgren, 2014; Lim et al, 2019), there has been controversy about the predictive efficacy of the Braden scale. The prediction efficiency of the Braden scale may decline due to the influence of multiple comorbidities in the older people (H. L. Chen et al, 2015; Grewal et al, 2021). For nurses to differentiate between different risk categories, cut‐off values are used, which then serve as a planning tool for the type and degree of preventative measures (Magnan & Maklebust, 2009).…”