Jenny Alderden1, Mollie Rebecca Cummins, Ginette Alyce Pepper, JoAnne D Whitney, Yingying Zhang, Ryan Butcher, Donna Thomas. 1. Jenny Alderden, PhD, APRN, CCRN, CCNS, Boise State University College of Nursing, Boise, Idaho. Mollie Rebecca Cummins, PhD, RN, FAAN, University of Utah College of Nursing, Salt Lake City; and University of Utah Center for Clinical and Translational Science, Salt Lake City. Ginette Alyce Pepper, PhD, RN, FAAN, University of Utah College of Nursing, Salt Lake City. JoAnne D. Whitney, PhD, RN, FAAN, University of Washington College of Nursing, Seattle. Yingying Zhang, MS, MSTAT, Division of Epidemiology, Department of Internal Medicine, University of Utah Center Study Design and Biostatistics Center, Salt Lake City. Ryan Butcher, MS, University of Utah Center for Clinical and Translational Science, Salt Lake City. Donna Thomas, BSN, CWOCN, University Hospital, Salt Lake City, Utah.
Abstract
PURPOSE: The purpose of the current study was to examine the relationship between pressure injury development and the Braden Scale for Pressure Sore Risk subscale scores in a surgical intensive care unit (ICU) population and to ascertain whether the risk represented by the subscale scores is different between older and younger patients. DESIGN: Retrospective review of electronic medical records. SUBJECTS AND SETTING: The sample comprised patients admitted to the ICU at an academic medical center in the Western United States (Utah) and Level 1 trauma center between January 1, 2008 and May 1, 2013. Analysis is based on data from 6377 patients. METHODS: Retrospective chart review was used 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. RESULTS: 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. CONCLUSION: 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.
PURPOSE: The purpose of the current study was to examine the relationship between pressure injury development and the Braden Scale for Pressure Sore Risk subscale scores in a surgical intensive care unit (ICU) population and to ascertain whether the risk represented by the subscale scores is different between older and younger patients. DESIGN: Retrospective review of electronic medical records. SUBJECTS AND SETTING: The sample comprised patients admitted to the ICU at an academic medical center in the Western United States (Utah) and Level 1 trauma center between January 1, 2008 and May 1, 2013. Analysis is based on data from 6377 patients. METHODS: Retrospective chart review was used 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. RESULTS: 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. CONCLUSION: 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.
Authors: Mona Baumgarten; David J Margolis; A Russell Localio; Sarah H Kagan; Robert A Lowe; Bruce Kinosian; Stephanie B Abbuhl; William Kavesh; John H Holmes; Althea Ruffin; Tesfa Mehari Journal: J Gerontol A Biol Sci Med Sci Date: 2008-04 Impact factor: 6.053