Health Professionals Education Coordinator, Oswaldo Cruz German Hospital, São Paulo, Brazil.
J Wound Ostomy Continence Nurs. 2009 Nov-Dec;36(6):640-6. doi: 10.1097/WON.0b013e3181bd86c9.
We sought to evaluate the predictive validity of the Waterlow Scale in hospitalized patients.
The study was conducted at a general private hospital with 220 beds and a mean time of hospitalization of 7.4 days and a mean occupation rate of approximately 80%. Adult patients with a Braden Scale score of 18 or less and a Waterlow Scale score of 16 or more were studied. The sample consisted of 98 patients with a mean age of 71.1 + or - 15.5 years.
Skin assessment and scoring by using the Waterlow and Braden scales were completed on alternate days. Patients were examined at least 3 times to be considered for analysis. The data were submitted to sensitivity and specificity analysis by using receiver operating characteristic (ROC) curves and positive (+LR) and negative (-LR) likelihood ratios.
The cutoff scores were 17, 20, and 20 in the first, second, and third assessment, respectively. Sensitivity was 71.4%, 85.7%, and 85.7% and specificity was 67.0%, 40.7%, and 32.9%, respectively. Analysis of the area under the ROC curve revealed good accuracy (0.64, 95% confidence interval [CI]: 0.35-0.93) only for the cutoff score 17 in the first assessment. The results also showed probabilities of 14%, 10%, and 9% for the development of pressure ulcer when the test results were positive (+LR) and of 3% (-LR) when the test results were negative for the cutoff scores in the first, second, and third assessment, respectively.
The Waterlow Scale achieved good predictive validity in predicting pressure ulcer in hospitalized patients when a cutoff score of 17 was used in the first assessment.
我们旨在评估 Waterlow 量表在住院患者中的预测效度。
本研究在一家拥有 220 张床位的综合性私立医院进行，平均住院时间为 7.4 天，平均入住率约为 80%。研究对象为 Braden 量表评分为 18 分或以下且 Waterlow 量表评分为 16 分或以上的成年患者。样本由 98 名平均年龄为 71.1 ± 15.5 岁的患者组成。
每隔一天使用 Waterlow 和 Braden 量表进行皮肤评估和评分。患者至少检查 3 次以进行分析。通过接受者操作特征（ROC）曲线和阳性（+LR）和阴性（-LR）似然比，对数据进行敏感性和特异性分析。
第 1、2 和 3 次评估的截断分数分别为 17、20 和 20。敏感性分别为 71.4%、85.7%和 85.7%，特异性分别为 67.0%、40.7%和 32.9%。ROC 曲线下面积分析显示，仅在第 1 次评估的截断分数为 17 时具有较好的准确性（0.64，95%置信区间[CI]：0.35-0.93）。结果还显示，在第 1、2 和 3 次评估中，当测试结果为阳性（+LR）时，发生压疮的概率分别为 14%、10%和 9%，当测试结果为阴性（-LR）时，概率分别为 3%。
当在第 1 次评估中使用 17 的截断分数时，Waterlow 量表在预测住院患者压疮方面具有良好的预测效度。
