The WOCN Society 40th Annual Conference (June 21-25th, 2008)


2421

Predictive Validity of Braden Scale for Hospitalized Patients

Carla M. Matuo1, Juliana Rosa da Silva Cardoso1, Letícia Faria Serpa, PhD, MSN, BSN2, and Vera Lúcia C. G. Santos, PhD, MSN, BSN, CWOCN, (TiSOBEST, -, Brazil)3. (1) Nursing College of the University of São Paulo, Nurse, Street Oscar Freire, 1518 ap 88 B, Sâo Paulo, Brazil, (2) German Oswaldo Cruz Hospital, Nurse, Rua das Uvaias 179, apto 84, Saúde/ Postal Code 04055-110, São Paulo, Brazil, (3) Nursing School of the University of São Paulo, Associate Professor, Av Dr Enéas de Carvalho Aguiar 419, Cerqueira Cesar/ Postal Code: 05403-000, São Paulo, Brazil

Aims: to evaluate the Braden scale's prediction value in hospitalized patients by determining the best cut-off score that indicates the risk of developing pressure ulcer. Methods: a prospective cohort study took place in a private general hospital with 220 beds divided among 13 hospitalization units of different specialties. Most of the patients attended by the hospital are of surgical nature and its average occupation rate is 7.4 days. Firstly the project was approved by Hospital Ethics Committee. The 6-month-period study was conducted with hospitalized adult patients with Braden score ≤18. All of them accepted to participate in the study. After consent patients were submitted to data collecting through alternate daily body examination and Braden scale assessment. During the hospitalization period, each patient was examined at least tree times to be considered for analysis. The data were submitted to sensitivity and specificity analysis through ROC curve and positive (+LR) and negative likelihood ratios (-LR). Results: Most of the 98 patients who composed the sample of the study aged > 71 years old (63.3%). The cut-off scores in the 1st, 2nd and 3rd examinations were 11, 13 and 13 respectively. Sensitivity percentages were 42.6%, 85.7% and 85.7% and for specificity they were 79.1%, 57.1% and 65.9% respectively. Areas under ROC revealed very good accuracy for the cut-off score at first evaluation (64/ CI95% 34 - 94) and good accuracy for the scores ate second and third evaluations (69/ CI95% 33 – 100; and 76/ CI95% 31 – 100 respectively). The results also showed probabilities of 14%, 13% and 16% for the development of pressure ulcers when the tests were positive (+LR) and 2%, 2% and 5% for negative tests (-LR) respectively for the first, second and third evaluations. Conclusion: The Braden scale showed good performance for pressure ulcer prediction for hospitalized patients with cut-off scores of 11 and 13 at three first evaluations.