Comparison Of The Predictive Effctiveness Of Three Pressure Ulcer Risk Assessment Scales Among Tumor Patients

Objective:The objectives of this study are to understand the general situation of pressure ulcers in tumor patients, to establish the critical cutoff sore of the modified Braden scale, China’s mainland scale and Waterlow scale in tumor patient and to compare the predictive of the three pressure ulcer risk assessment tools.Method:the research objects were chosen from the Department of medical oncology in Guangxi from January to November of2012.The researcher used three pressure ulcer assessment scales (the modified Braden scale, China’s mainland scale and Waterlow scale) to assess and investigate pressure ulcer risks in patients admitted in48h,then observed the skin conditions until the patients were discharged to home developing pressure ulcers, going to another department,or death. Pressure ulcer’s site, stage, time of occurrence were recorded.Result:Patients who did not conform to the standard or with repeated admission were excluded,29patients with pressure ulcer when admitted were excluded as well,314patients were collected with54pressure ulcer cases pressure ulcer incidence rate was24.20%, the prevalence rate was15.74%. there were71sites In54patients with pressure ulcers, pressure ulcers stage Ⅰ was34(47.89%), stage Ⅱ was36(50.70%), stage Ⅲ was1(1.41%), the high incidence area of pressure sore is sacrococcygeal region, followed by pars iliaca.In all groups of patients with risk, there were214male cases (68.15%) and100female cases (31.85%).33cases of the male group occurred pressure ulcer (61.10%),21cases of the male group developed pressure ulcer (38.90%),181male patients did not occur pressure ulcer (69.60%), female79cases (30.40%).The occurrence time of pressure ulcer in tumor patients was7.92±4.79days, stage Ⅰ was5.73±3.64days, stage Ⅱ is9.53±5.00days.The modified Braden scale was applied to evaluate the risk of pressure ulcer occurrence in tumor patients. When the field value is defined as18, the predictive effectiveness is ideal, the sensitivity, specificity, positive predictive value, and negative predictive value were38.89%,68.46%,20.39%,84.36%respectively. The China’s mainland scale was applied to assess the risk of pressure ulcer occurrence in tumor patients, When the field value is defined as24, the predictive effectiveness is ideal, the sensitivity, specificity, positive predictive value, and negative predictive value were55.56%,50.38%,18.87%,84.52%respectively.The Waterlow scale was applied to assess the risk of pressure ulcer occurrence in tumor patients, When the field value was defined as16, the predictive effectiveness is ideal, the sensitivity, specificity, positive predictive value, and negative predictive value were44.44%,64.23%,20.51%,84.77%.ROC curve evaluation areas of the modified Braden, China’s mainland scale and Waterlow scale were0.530,0.520,0.553.Conclusion:Tumor patients are a high risk group for the hospital-acquired pressure ulcer, especially in long time bed-ridden patients, The first week after admission is the peak period of the occurrence for pressure ulcer. Medical workers should timely assess patients, and take the corresponding preventive measures.Through the indicators, three pressure ulcer assessment scales (the modified Braden scale, China’s mainland scale and Waterlow scale) can be used to assess the risk of pressure ulcer in the tumor patients. But the sensitivity and specificity of the three pressure ulcer assessment scales are not ideal, the predictiveness effectiveness of the Waterlow scale is relatively good, with the recommended value16points. In addition, the application of pressure ulcer risk assessment scale in tumor patients remains to be further studied, so as to improve the predictive effectiveness in clinical practice...