Perneger Thomas V, Raë Anne Claire, Gaspoz Jean Michel, Borst François, Vitek Olga, Héliot Céliane
Quality of Care Unit, Geneva University Hospitals, CH-1211 Geneva 14, Switzerland.
J Clin Epidemiol. 2002 May;55(5):498-504. doi: 10.1016/s0895-4356(01)00514-5.
To derive a brief bedside pressure ulcer prediction tool for patients admitted to acute care hospitals, we conducted a prospective study of first pressure ulcer incidence among 1,190 consecutive patients hospitalized in selected wards of a Swiss teaching hospital. Baseline predictors included patient age and items from the Norton and Braden ulcer prediction scales. During follow-up, 170 patients developed new pressure ulcers. The predictive ability of baseline assessments decayed over time. Occurrence of first pressure ulcer in the 5 days after admission (129 events) was best predicted by patient age (5 levels), mobility (3 levels), mental status (3 levels), and friction/shear (3 levels). The Fragmment score (sum of friction, age, mobility, mental status) was linearly related to pressure ulcer risk, and its area under the receiver operating characteristic curve (0.80) was higher than for the Norton (0.74; P = 0.006) and Braden (0.74; P = 0.004) scores. This brief pressure ulcer prediction scale performed well in an acute care setting. Use of this scale may facilitate the implementation of pressure ulcer prevention interventions.
为了得出一种适用于急症医院住院患者的简易床旁压疮预测工具，我们对瑞士一家教学医院特定病房连续收治的1190例患者的首次压疮发生率进行了一项前瞻性研究。基线预测因素包括患者年龄以及诺顿和布拉德恩压疮预测量表中的项目。在随访期间，170例患者出现了新的压疮。基线评估的预测能力随时间衰减。入院后5天内首次发生压疮（129例事件）的最佳预测因素为患者年龄（5个等级）、活动能力（3个等级）、精神状态（3个等级）和摩擦力/剪切力（3个等级）。碎片评分（摩擦力、年龄、活动能力、精神状态的总和）与压疮风险呈线性相关，其受试者工作特征曲线下面积（0.80）高于诺顿量表（0.74；P = 0.006）和布拉德恩量表（0.74；P = 0.004）。这种简易压疮预测量表在急症护理环境中表现良好。使用该量表可能有助于实施压疮预防干预措施。
