Can Huang1,2, Yuxia Ma1,3, Chenxia Wang4, Mengyao Jiang1, Loretta Yuet Foon1, Lin Lv1,4, Lin Han1,4. 1. Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China. 2. Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, China. 3. The First Clinical Medical College, Lanzhou University, Lanzhou, China. 4. Nursing Department, Gansu Provincial Hospital, Lanzhou, China.
Abstract
AIM: Pressure injuries are common adverse events in clinical practice, affecting the well-being of patients and causing considerable financial burden to healthcare systems. It is therefore essential to use reliable assessment tools to identify pressure injuries for early prevention. The Braden Scale is a widely used tool to assess pressure injury risk, but the literature is currently lacking in determining its accuracy. This study aimed to evaluate the accuracy of the Braden Scale in assessing pressure injury risk. DESIGN: Systematic review and meta-analysis. METHODS: Articles published between 1973-2020 from periodicals indexed in the PubMed, EMBASE, CINAHL, Web of Science and the Cochrane Library were selected. Two reviewers independently selected the relevant studies for inclusion. Data were analysed by the STATA 15.0 and the RevMan 5.3 software. RESULTS: In total, 60 studies involving 49,326 individuals were eligible for this meta-analysis. The pooled SEN, SPE, PLR, NLR, DOR and AUC were 0.78 (95% CI: 0.74 to 0.82), 0.72 (95% CI: 0.66 to 0.78), 2.80 (95% CI: 2.30 to 3.50), 0.30 (95% CI: 0.26 to 0.35), 9.00 (95% CI: 7.00 to 13.00) and 0.82 (95% CI: 0.79 to 0.85), respectively. Subgroup analyses indicated that the AUC was higher for prospective design (0.84, 95% CI: 0.81 to 0.87), mean age <60 years (0.87, 95% CI: 0.84 to 0.90), hospital (0.82, 95% CI: 0.79 to 0.86) and Caucasian population (0.86, 95% CI: 0.82 to 0.88). In addition, 18 was found to be the optimal cut-off value. CONCLUSION: The evidence indicated that the Braden Scale had a moderate predictive validity. It was more suitable for mean age <60 years, hospitalized patients and the Caucasian population, and the cut-off value of 18 might be used for the risk assessment of pressure injuries in clinical practice. However, due to the different cut-off values used among included studies, the results had a significant heterogeneity. Future studies should explore the optimal cut-off value in the same clinical environment.
AIM: Pressure injuries are common adverse events in clinical practice, affecting the well-being of patients and causing considerable financial burden to healthcare systems. It is therefore essential to use reliable assessment tools to identify pressure injuries for early prevention. The Braden Scale is a widely used tool to assess pressure injury risk, but the literature is currently lacking in determining its accuracy. This study aimed to evaluate the accuracy of the Braden Scale in assessing pressure injury risk. DESIGN: Systematic review and meta-analysis. METHODS: Articles published between 1973-2020 from periodicals indexed in the PubMed, EMBASE, CINAHL, Web of Science and the Cochrane Library were selected. Two reviewers independently selected the relevant studies for inclusion. Data were analysed by the STATA 15.0 and the RevMan 5.3 software. RESULTS: In total, 60 studies involving 49,326 individuals were eligible for this meta-analysis. The pooled SEN, SPE, PLR, NLR, DOR and AUC were 0.78 (95% CI: 0.74 to 0.82), 0.72 (95% CI: 0.66 to 0.78), 2.80 (95% CI: 2.30 to 3.50), 0.30 (95% CI: 0.26 to 0.35), 9.00 (95% CI: 7.00 to 13.00) and 0.82 (95% CI: 0.79 to 0.85), respectively. Subgroup analyses indicated that the AUC was higher for prospective design (0.84, 95% CI: 0.81 to 0.87), mean age <60 years (0.87, 95% CI: 0.84 to 0.90), hospital (0.82, 95% CI: 0.79 to 0.86) and Caucasian population (0.86, 95% CI: 0.82 to 0.88). In addition, 18 was found to be the optimal cut-off value. CONCLUSION: The evidence indicated that the Braden Scale had a moderate predictive validity. It was more suitable for mean age <60 years, hospitalized patients and the Caucasian population, and the cut-off value of 18 might be used for the risk assessment of pressure injuries in clinical practice. However, due to the different cut-off values used among included studies, the results had a significant heterogeneity. Future studies should explore the optimal cut-off value in the same clinical environment.
Authors: Jenny Alderden; Susan M Kennerly; Andrew Wilson; Jonathan Dimas; Casey McFarland; David Y Yap; Lucy Zhao; Tracey L Yap Journal: Comput Inform Nurs Date: 2022-10-01 Impact factor: 2.146