| Objective:To compare and evaluate the prediction effect of intraoperation-acqui-ed pressure injury risk assessment scale,Braden stress injury risk assessment scale and Munro perioperative pressure injury risk assessment scale for adult patients undergoing elective surgery,and to provide the basis for clinical selection and use of appropriate scale.METHODS:A total of 237 patients with elective surgery from December 2019 to June 2020 were selected from two tertiary,first-level hospitals.Two on-the-job graduate students majoring in wound stomy and four nurses with a bachelor’s degree who have worked in the operating room for 10 years and obtained intermediate professional title were selected as members of the investigation team.Before the start of the experiment,the investigators finally reached a unified standard through the detailed explanation of the definition of pressure injury,staging standard and each item of the three risk assessment scales by the master graduate tutor with international ostomy treatment teachers.After the training,the experiment was officially started.On the day of surgery,three investigators from each hospital simultaneously and independently evaluated the same patient with three evaluation scales before the surgery,at the end of the surgery,and when they left the anesthetic resuscitation room.They did not meet and communicate with each other,and recorded the patient’s basic information,scale evaluation score,and evaluation time.At the end of the operation and when they left the anesthesia recovery room,the two graduate students respectively used transparent tubes to press the compressed skin for skin examination.One of the graduate students checked the daily evaluation scale and entered the data,while the other graduate student reviewed the input data.Through statistical analysis,the prediction effect and evaluation time of the three scales were compared.Results:9 departments were investigated,including 74 cases in orthopedics department,32 cases in neurosurgery department,15 cases in cardiac surgery department,27 cases outside tumor department,9 cases in general surgery department,16 cases in thoracic surgery department,18 cases in urology department,44 cases in gynecology department and 2 cases in breast department.In this study,there were 192 cases in the non-pressure injury group,including 79 males and 113 females,with an average age of 58.50±11.78 and an average BMI of 23.79±3.09.The mean operation time was 3.13±0.95.In the stress injury group,there were 45 patients,including 18 males and 27 females,with an average age of 61.578±12.041,an average BMI of24.70±3.23,and an average operative time of 4.82±1.19.The AUC of preoperative area under the ROC curve was 0.695,0.619 and 0.684,respectively,for the Intraoperation-acquied pressure injury Risk Assessment Scale,Braden pressure Injury Risk Assessment Scale,and Munro pressure Injury Risk Assessment Scale for Perioperative Adult;The AUC of the area under the ROC curve was 0.848,0.633 and 0.882,respectively.The AUC of the area under the ROC curve was 0.861,0.757 and 0.870,respectively.Before surgery,the maximum score of the Youden index of the risk assessment scale for Intraoperation-acquied pressure injury was 0.372,with a good sensitivity of 0.778,and the maximum negative predictive value of 91.94%.During the operation,the maximum deliberate degree was 0.859;Postoperatively,the best balance of sensitivity and deliberate degree was 0.800 and 0.755,respectively.Multiple comparative analysis of variance was used for the evaluation of the three scales.Before surgery:The assessment time of the Intraoperation-acquied pressure Injury Risk Assessment Scale(3.11±0.44)and the Braden Pressure Injury Risk Assessment Scale(4.27±0.55)were significantly lower than that of the Munro Perioperative Adult Stress Injury Risk Assessment Scale(23.56±4.24).The Braden Pressure Injury Risk Assessment Scale was longer than the Intraoperation-acquied pressure injury Risk Assessment Scale.Intraoperative:The assessment time of the Intraoperation-acquied pressure Injury Risk Assessment Scale(2.71±0.46)and the Braden Pressure Injury Risk Assessment Scale(3.51±0.52)were significantly lower than the Munro Peri-operative Adult Pressure Injury Risk Assessment Scale(24.43±4.59).The Braden Pressure Injury Risk Assessment Scale was longer than the Intraoperation-acquied pressure Injury Risk Assessment Scale.After:The evaluation time of the Intraoperation-acquied pressure Injury Risk Assessment Scale(2.94±0.43)and the Braden Pressure Injury Risk Assessment Scale(3.51±1.56)were significantly lower than that of the Munro Perioperative Adult Pressure Injury Risk Assessment Scale(10.01±3.84).The evaluation time of Braden pressure injury risk assessment scale was higher than that of the Intraoperation-acquied pressure injury risk assessment scale.It was concluded that the evaluation time of the Intraoperation-acquied pressure injury risk assessment scale was the shortest in the three periods.Conclusion:The risk assessment scale of intraoperation-acquied pressure injury not only has a good predictive ability for patients with intraoperation-acquied pressure injury,but also takes a short time to evaluate,is convenient to use,and is worthy of clinical application. |
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