van Marum R J, Ooms M E, Ribbe M W, van Eijk J T
Department of General Practice, Nursing Home Medicine and Social Medicine/Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Age Ageing. 2000 Jan;29(1):63-8. doi: 10.1093/ageing/29.1.63.
To investigate the usefulness of a Dutch pressure sore risk assessment scale--the Centraal Begeleidingsorgaan voor de Intercollegiale Toetsing (CBO; National Organization for Quality Assurance in Hospitals) score--in the detection of patients at risk of developing pressure sores after admission to a nursing home. As the Norton score is the standard method of risk assessment, we also investigated which score (Norton or CBO) has the stronger relationship to the development of pressure sores.
Longitudinal cohort design.
220 nursing home patients, 80 men, 140 women, mean age 79 years (standard deviation 3).
Admission assessments for the presence of pressure sores, CBO and Norton scores, preventive measures and demographic characteristics. We made observations every week for 4 weeks.
Presence or absence of pressure sores.
54 patients (25%) developed a pressure sore. A significant, nonlinear relationship was found between the CBO score on admission and the development of pressure ulcers for the first 2 weeks after admission. Multiple logistic regression analysis showed that only mobility (odds ratio = 3.6, P = 0.0001) and mental state (odds ratio = 2.0, P = 0.03) showed a significant relationship with the development of pressure ulcers. The CBO score was no better in risk assessment than the Norton score.
The CBO score can be used for assessment of the risk of developing pressure ulcers in the first 2 weeks after admission to a nursing home, but is no better than the Norton score. Since the Norton score is easier to use, it is slightly preferable for use in this setting. However, neither score is a good indicator of patients at risk. Physicians should not depend solely on risk scores when prescribing preventive measures.
研究一种荷兰压疮风险评估量表——中央护理质量评估组织（CBO）评分——在检测入住养老院后有发生压疮风险患者方面的效用。由于诺顿评分是风险评估的标准方法，我们还研究了哪个评分（诺顿或CBO）与压疮的发生有更强的关联。
纵向队列研究设计。
220名养老院患者，80名男性，140名女性，平均年龄79岁（标准差3）。
入院时对压疮、CBO和诺顿评分、预防措施及人口统计学特征的评估。我们连续4周每周进行观察。
是否发生压疮。
54名患者（25%）发生了压疮。入院时的CBO评分与入院后前2周压疮的发生之间存在显著的非线性关系。多因素逻辑回归分析显示，只有活动能力（比值比 = 3.6，P = 0.0001）和精神状态（比值比 = 2.0，P = 0.03）与压疮的发生有显著关联。CBO评分在风险评估方面并不比诺顿评分更好。
CBO评分可用于评估入住养老院后前2周发生压疮的风险，但并不比诺顿评分更好。由于诺顿评分使用更简便，在这种情况下略占优势。然而，这两个评分都不是风险患者的良好指标。医生在制定预防措施时不应仅依赖风险评分。
