Validez predictiva y fiabilidad de la escala de Braden para valoración del riesgo de úlceras por presión en una unidad de cuidados intensivos / Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit

Objetivo: Contribuir a la validación de la escala de Braden en el paciente ingresado en la UCI mediante un análisis de su fiabilidad y validez predictiva. Diseño: Analítico, observacional, longitudinal y prospectivo. Ámbito: Unidad de Cuidados Intensivos del Hospital Virgen del Rocío (Sevilla). Pacientes: Se incluyeron los pacientes de 18años o más que permanecieron ingresados en la unidad durante más de 24h. Fueron excluidos los pacientes que presentaron úlceras por presión al ingreso. En total, 335 pacientes fueron incluidos durante dos períodos de estudio de un mes de duración cada uno de ellos. Intervenciones: Ninguna. Variables de interés principales: Como variable principal se consideró la aparición de UPP en estadios delI alIV. Para el resto de variables se tomaron 3 categorías: demográficas, clínicas y de pronóstico. Resultados: La incidencia de pacientes que desarrollaron úlceras por presión fue del 8,1%. Un 40,6% han sido de estadioI y un 59,4% de estadioII, destacando el sacro como localización más frecuente. El valor del coeficiente alfa de Cronbach en las valoraciones consideradas ha indicado una fiabilidad de buena a moderada. En las 3 valoraciones realizadas un punto de corte de 12 se presentó como óptimo en la valoración del primer y segundo días de ingreso. En relación a la valoración del día con puntuación mínima, el punto de corte óptimo fue 10. Conclusiones: La escala de Braden muestra una insuficiente validez predictiva y pobre precisión tanto para un punto de corte de 18 como de 16, que son los aceptados en los distintos escenarios clínicos (AU)

Objective: Contribution to validation of the Braden scale in patients admitted to the ICU, based on an analysis of its reliability and predictive validity. Design: An analytical, observational, longitudinal prospective study was carried out. Setting: Intensive Care Unit, Hospital Virgen del Rocío, Seville (Spain). Patients: Patients aged 18years or older and admitted for over 24hours to the ICU were included. Patients with pressure ulcers upon admission were excluded. A total of 335 patients were enrolled in two study periods of one month each. Interventions: None. Variables of interest: The presence of gradeI-IV pressure ulcers was regarded as the main or dependent variable. Three categories were considered (demographic, clinical and prognostic) for the remaining variables. Results: The incidence of patients who developed pressure ulcers was 8.1%. The proportion of gradeIandII pressure ulcer was 40.6% and 59.4% respectively, highlighting the sacrum as the most frequently affected location. Cronbach's alpha coefficient in the assessments considered indicated good to moderate reliability. In the three evaluations made, a cutoff point of 12 was presented as optimal in the assessment of the first and second days of admission. In relation to the assessment of the day with minimum score, the optimal cutoff point was 10. Conclusions: The Braden scale shows insufficient predictive validity and poor precision for cutoff points of both 18 and 16, which are those accepted in the different clinical scenarios (AU)

Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. / Validez predictiva y fiabilidad de la escala de Braden para valoración del riesgo de úlceras por presión en una unidad de cuidados intensivos.

OBJECTIVE: Contribution to validation of the Braden scale in patients admitted to the ICU, based on an analysis of its reliability and predictive validity. DESIGN: An analytical, observational, longitudinal prospective study was carried out. SETTING: Intensive Care Unit, Hospital Virgen del Rocío, Seville (Spain). PATIENTS: Patients aged 18years or older and admitted for over 24hours to the ICU were included. Patients with pressure ulcers upon admission were excluded. A total of 335 patients were enrolled in two study periods of one month each. INTERVENTIONS: None. VARIABLES OF INTEREST: The presence of gradei-iv pressure ulcers was regarded as the main or dependent variable. Three categories were considered (demographic, clinical and prognostic) for the remaining variables. RESULTS: The incidence of patients who developed pressure ulcers was 8.1%. The proportion of gradei andii pressure ulcer was 40.6% and 59.4% respectively, highlighting the sacrum as the most frequently affected location. Cronbach's alpha coefficient in the assessments considered indicated good to moderate reliability. In the three evaluations made, a cutoff point of 12 was presented as optimal in the assessment of the first and second days of admission. In relation to the assessment of the day with minimum score, the optimal cutoff point was 10. CONCLUSIONS: The Braden scale shows insufficient predictive validity and poor precision for cutoff points of both 18 and 16, which are those accepted in the different clinical scenarios.