[Validity study of the current risk assessment scale for pressure ulcers in intensive care (EVARUCI)]. / Estudio de validez de la Escala de Valoración Actual del Riesgo de desarrollar Ulceras por presión en Cuidados Intensivos (EVARUCI).

UNLABELLED: Pressure ulcers (PU) are the most frequent injuries in critical patients whose management is the responsibility of the nurses. The first step for its prevention is to determine the patients at risk; however the usual risk assessment scales (Norton, Braden, etc.) do not have adequate specificity to do this. AIM: To study the validity of a current risk assessment scale of pressure ulcers in intensive care (EVARUCI). DESIGN: Prospective, descriptive study. SUBJECTS: Adult patients admitted to Intensive Care Unit (ICU) in the Hospital of Fuenlabrada without PU from February, the 1st, 2005 to January, the 31st, 2006. Demographic data were obtained from the admission records. Data on EVARUCI were daily collected and the patients were studied until they developed 1 of 2 outcomes: a) they developed a PU, or b) they left the ICU (death or exit to other nursing ward). METHODS: Four validity indexes were used: sensitivity, specificity, positive predictive value and negative predictive value. The area under the curve (AUC) of the receiver operating characteristic (ROC) was also used. These indicators were applied to the mean scores during the entire stay and to the initial and final scores in both groups (PU and NO PU). The SPSS v. 12.0 was used for the statistical analysis. RESULTS: A total of 97 patients were included, 62 of whom finished the study. Eleven patients (17.74%) developed PU. Of these, 57.69% were grade I. The most frequent site was in the sacral area (26.92%) and heels (23.08%). The results of the mean of the scores on the EVARUCI mean, initial and final data were: sensitivity (100%, 100%, 90.91%), specificity (68.63%, 49.02%, 92.16%), positive predictive value (40.74%, 29.73%, 71.43%) and negative predictive value (100%, 100%, 97.2%). AUC of ROC was 0.938, 0.909, 0.952, respectively. CONCLUSIONS: The EVARUCI scale is valid to detect patients at risk of development PU in ICU.

Estudio de validez de la Escala de Valoración Actual del Riesgo de desarrollar Úlceras por presión en Cuidados Intensivos (EVARUCI) / Validity study of the current risk assessment scale for pressure ulcers in intensive care (EVARUCI)

Las úlceras por presión (UPP) son lesiones másfrecuentes en los pacientes críticos y su manejo escompetencia de la enfermera. El primer paso para suprevención consiste en la determinación del riesgo ypara ello las escalas habituales (Norton, Braden, etc.)no tienen una adecuada especificidad.Objetivo. Determinar la validez de la Escala deValoración Actual del Riesgo de desarrollar Úlceraspor presión en Cuidados Intensivos (EVARUCI).Diseño. Estudio prospectivo descriptivo.Sujetos. Pacientes adultos ingresados en la Unidad deCuidados Intensivos (UCI) del Hospital deFuenlabrada sin UPP entre el 1 de febrero de 2005 yel 31 de enero de 2006. Los datos demográficosfueron obtenidos de admisión y diariamente se evaluóy registró la puntuación obtenida en EVARUCI. Lospacientes siguieron en el estudio hasta quedesarrollaron UPP (grupo UPP), o salieron de la UCIpor muerte o traslado (grupo NO UPP).Metodología. Se emplearon 4 indicadores de validez:sensibilidad, especificidad, valor predictivo positivo yvalor predictivo negativo. También se empleó el áreabajo la curva ROC (receiver operatingcharacteristic). Estos indicadores se aplicaron a lamedia de las puntuaciones durante toda la estancia, ya las puntuaciones iniciales y a las finales en ambosgrupos (UPP y NO UPP); para el análisis estadístico seaplicó el paquete SPSS v. 12.0.Resultados. Noventa y siete pacientes fueronincluidos, de los que 62 finalizaron el estudio.Desarrollaron UPP 11 pacientes (17,74%). El 57,69%fue de grado I; la localización más frecuente fue enzona sacra (26,92%) y talones 23,08%. Los resultadosde la media de las puntuaciones en EVARUCI, laspuntuaciones iniciales y finales fueron: sensibilidad(100%, 100%, 90,91%), especificidad (68,63%,49,02%, 92,16%), valor predictivo positivo (40,74%,29,73%, 71,43%), valor predictivo negativo (100%,100%, 97,2%). El área bajo la curva ROC fue de 0,938,0,909 y 0,952 respectivamente.Conclusiones. La escala EVARUCI es válida para detectarpacientes críticos con riesgo de desarrollar UPP

Aim. To study the validity of a current riskassessment scale of pressure ulcers in intensive care(EVARUCI).Design. Prospective, descriptive study.Subjects. Adult patients admitted to Intensive CareUnit (ICU) in the Hospital of Fuenlabrada withoutPU from February, the 1st, 2005 to January, the 31st,2006. Demographic data were obtained from theadmission records. Data on EVARUCI were dailycollected and the patients were studied until theydeveloped 1 of 2 outcomes: a) they developed a PU,or b) they left the ICU (death or exit to othernursing ward).Methods. Four validity indexes were used:sensitivity, specificity, positive predictive value andnegative predictive value. The area under the curve(AUC) of the receiver operating characteristic(ROC) was also used. These indicators were appliedto the mean scores during the entire stay and to theinitial and final scores in both groups (PU and NOPU). The SPSS v. 12.0 was used for the statisticalanalysis.Results. A total of 97 patients were included, 62 ofwhom finished the study. Eleven patients (17.74%)developed PU. Of these, 57.69% were grade I. Themost frequent site was in the sacral area (26.92%)and heels (23.08%). The results of the mean of thescores on the EVARUCI mean, initial and final datawere: sensitivity (100%, 100%, 90.91%), specificity(68.63%, 49.02%, 92.16%), positive predictive value(40.74%, 29.73%, 71.43%) and negative predictivevalue (100%, 100%, 97.2%). AUC of ROC was 0.938,0.909, 0.952, respectively.Conclusions. The EVARUCI scale is valid to detectpatients at risk of development PU in ICU