| ObjectiveThe validity of the Braden scale,Norton scale and Waterlow scale in predicting the risk of pressure ulcers in perioperative patients were compared,and a pressure ulcer risk assessment scale suitable for surgical patients was selected.Methods1561 perioperative patients from a top three hospital in Zhengzhou from December 2017 to September 2018 were selected.According to the research purpose and clinical practice,wedesigned a data collection table to collect theage,sex,operation time,operation position,anesthesia method,pressure ulcer occurrence and other information,such as pressure ulcer occurrence site,occurrence time,pressure ulcer staging.The risk of pressure ulcers was assessed by different assessors at 24 hours before surgery(T1),when entering the anesthesia recovery room after surgery(T2),at time of patient gets out of bed for the first time after surgery(T3)using the Braden scale,the Norton scale,and the Waterlow scale.The predictive validity of three scales were evaluated using the sensitivity,specificity,and area under the curve(AUC)of the Receiver Operating Characteristic Curve(ROC).Results1 In this study,about 1561 patients were enrolled,a total of 35 patients developed pressure ulcers,the incidence rate was 2.24%,all of which were stage I pressure sores.According to the site of occurrence,pressure sores were located on sacrococcygeal region in 19 cases(54.29%),located on buttocks in 9 cases(25.71%),located on hi ps in 5 case(14.29%)and located on arms in 2 case(5.71%).There were 22 female patients(62.9%)and 13 male patients(37.1%);the average age was(51.09 ± 1.02);9 patients(25.7%)were cardiovascular surgery,8 patients(22.9%)were thoracic surgery,and urology 4 cases(11.4%),5 cases of gastrointestinal surgery(14.3%),4 cases of neurosurgery(11.4%),2 cases of orthopedics(5.7%),2 cases of breast surgery(5.7%),1 case of plastic surgery(2.8%)).2 At TI,T2 and T3 time points,the scores of Braden scale and Norton scale in patients with pressure ulcer were significantly higher than those in patients without pressure ulcer,while the scores of Waterlow scale were significantly lower than those in patients without pressure ulcer(P<0.05).3 The AUCs of Braden scale at T1,T2 and T3 time points were 0.650,0.674 and 0.735 respectively;the AUCs of Norton scale at T1,T2 and T3 time points were 0.608,0.657 and 0.677 respectively;the AUCs of Waterlow scale at T1,T2 and T3 time points were 0.728,0.751 and 0.804 respectively.The sensitivity of Braden scale at T1,T2 and T3 time points was 84.0%,75.2%and 81.7%respectively;the sensitivity of Norton scale at T1,T2 and T3 time points was 79.5%,59.6%and 48.6%respectively;the sensitivity of Waterlow scale at T1,T2 and T3 time points was 82.8%,74.2%and 76.1%,respectively.The specificity of Braden scale at T1,T2 and T3 time points was 60.0%,57.1%and 54.3%respectively;the specificity of Norton scale at T1,T2 and T3 time points was 37.1%,68.6%and 80.0%respectively;the specificity of Waterlow scale at T1,T2 and T3 time points was 54.3%,68.6%and 74.3%,respectively.Conclusions1 The sacral tail of patients are at high risk for pressure ulcers.Medical staff should timely and accurately assess the risk of pressure ulcers and provide targeted preventive measures to reduce the incidence of perioperative pressure ulcers.2 The Braden scale has the best sensitivity for predicting the risk of perioperative pressure ulcers in surgical patients,but the AUC is inferior to the Waterlow scale;the Waterlow scale predicts the best AUC for perioperative pressure ulcers in surgical patients.Comprehensive comparison,the Waterlow pressure ulcer assessment scale has a better predictive effect when assessing pressure ulcers in perioperative patients. |
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