A pressure injury risk prognosis model for severe trauma patients based on Braden scale combined with microcirculation indicators / 中华急诊医学杂志

ABSTRACT

Objective:Based on Braden scale, combined with local skin temperature and local tissue oxygen saturation as microcirculation indicators, to construct a pressure injury risk prognosis model for severe trauma patients, and develop a visual nomogram.Methods:All the trauma patients in the Emergency Intensive Care Unit (EICU) of a tertiary hospital in Zhejiang Province from June 1, 2020 to August 31, 2020 were selected. The Braden scale was used to assess the risk of pressure injury in the patient and measure the patient’s sacral injury. The skin temperature and blood oxygen saturation at the pressure site were used as indicators for microcirculation evaluation. Multivariate Logistic regression was used to construct a prognostic model and visual nomogram for severe trauma patients with stress injury based on Braden score combined with microcirculation evaluation indicators, and compared with the prediction model constructed by the Braden scale alone. The discrimination degree was judged by the area under the receiver operating characteristic curve. The C index performed internal verification of the model, H-L goodness-of-fit test, and the overall discrimination index to observe and predict the effect of the model.Results:A total of 152 patients were enrolled in this study, of which 33 (21.71%) had pressure injuries. The area under the curve of the Braden scale combined with local skin temperature and local tissue oxygen saturation was 0.866, and the internal verification C index of the model was 0.847. The H-L goodness of fit test result was 8.37 ( P=0.051), indicating that the model had good discrimination and consistency. The overall discrimination index of the model was 0.144 ( P=0.023). Conclusions:The Braden scale combined with local microcirculation indicators to construct a prognostic model of stress injury in severe trauma patients has good discrimination and consistency, and the predictive power of the Braden scale is improved by 14.4%. The construction of a nomogram can provide clinical rapid convenient and reliable forecasting tool.