The Application Of Three Pressure Injury Risk Assessment Scales In The Risk Assessment Of Pressure Injury After Cardiac Surgery In ICU

Objective: Through understanding the pressure injury factors of ICU cardiac surgery postoperative patients with extracorporeal circulation in low temperature,compared with Braden scale,Chinese version of COMHON scale and Chinese version of Cubbin&Jackson scale in the application effect and the optimal critical value of pressure injury risk assessment of patients after low-temperature extracorporeal circulation in ICU cardiac surgery,to make the ICU cardiac surgery postoperative patients with extracorporeal circulation in low temperature pressure injury risk assessment scale.Methods:Used the Braden scale,Chinese version of COMHON scale and Chinese version of Cubbin&Jackson scale to evaluate and nursing the risk of stress injury of 252 patients who met the inclusion and exclusion criteria after low-temperature cardiopulmonary bypass(CPB)in ICU cardiac surgery department admitted to a grade a hospital in Urumqi,XinJiang from July 2017 to December 2018.The data were analyzed by SPSS21.0 and medcal 15.2 statistical software.Results:(1)The incidence of pressure injury in ICU cardiac surgery patients after low-temperature extracorporeal circulation is as high as 33.54%;age,gender,length of extracorporeal circulation,intraoperative blood transfusion volume and intraoperative minimum body temperature were the influencing factors of stress injury after ICU cardiac surgery(P<0.05).(2)Braden’s scores in the dimensions of perceived ability and activity ability are related to the occurrence of pressure injuries.When the diagnostic boundary value of Braden evaluation scale was 11 points,the application effect was the best in the risk assessment of pressure injury after low-temperature extracorporal circulation in ICU cardiac surgery,and the corresponding sensitivity,specificity,positive predictive value and negative predictive value were74.67%,23.53%,58.90% and 38.70%,respectively.(3)The scores and total scores of all dimensions in COMHON scale are irrelevant to the occurrence of pressure injury.Whenthe diagnostic boundary value of COMHON assessment scale is 16 points,the application effect is the best in the risk assessment of pressure injury after low-temperature extracorporal circulation in ICU cardiac surgery,and the corresponding sensitivity,specificity,positive predictive value and negative predictive value were 92.00%,1.96%,58.00% and 14.30%,respectively.(4)Cubbin&Jackson scale total score is related to the occurrence of pressure injury.When the cutoff value of the Cubbin&Jackson evaluation scale was 25 points,the cutoff value was the best in the risk assessment of pressure injury in ICU cardiac surgery patients after low-temperature cardiopulmonary bypass,and the corresponding sensitivity,specificity,positive predictive value,negative predictive value were 93.33%,30.39%,41.51% and 82.00% respectively.(5)The Yoden index of Braden scale,COMHON scale and Cubbin&Jackson scale were 0.038,0.111,0.294,and the area under the ROC curve were 0.512,0.523,and 0.687,respectively.Conclusion:(1)ICU cardiac surgery postoperative patients with extracorporeal circulation in low temperature damage pressure of high-risk groups,should choose the right pressure injury risk assessment tool for accurate evaluation,according to age,gender,intraoperative blood transfusion amount,extracorporeal circulation time,intraoperative risk factors such as the minimum temperature for prevention and personalized nursing measures,reduce the incidence of pressure injury.(2)Braden scale and COMHON scale are not suitable for the first evaluation of patients in ICU after low-temperature cardiopulmonary bypass surgery.Compared with Braden and COMHON scales,Cubbin&Jackson scale is more suitable for the risk assessment of pressure injury in ICU cardiac surgery patients after cardiopulmonary bypass.The Cubbin&Jackson scale had a diagnostic threshold of 25 points in predicting the risk of pressure injury,which was better than the Braden’s threshold of 11 points and the COMHON scale’s threshold of 16 points.