Whittington Health NHS Trust, London, UK.
University Hospitals of Leicester NHS Trust, UK.
Ann R Coll Surg Engl. 2021 May;103(5):312-317. doi: 10.1308/rcsann.2020.7136. Epub 2021 Apr 14.
The Waterlow score (WS) is used routinely in clinical practice to assess risk of pressure sore development. Recent studies have also suggested its use in preoperative risk stratification. The primary aim of this systematic review was to evaluate the current evidence on the WS in predicting morbidity and mortality in surgical patients.
A systematic review was carried out in accordance with PRISMA and SWiM guidelines. A search strategy was conducted on the MEDLINE and EMBASE databases. Quality was assessed using the Newcastle-Ottawa scale.
Overall, 72 papers were identified, of which 7 met inclusion criteria for full text review, and 4 were included for analysis. All studies were cohort in nature and published between 2013 and 2016, encompassing a total of 505 surgical patients. The studies included general, vascular, transplant and orthopaedic surgery. A high WS was demonstrated to have statistically significant association with increased morbidity and mortality as well as need for intensive care unit admission and length of stay. Furthermore, this was a more accurate predictor compared with the P-POSSUM and ASA scoring systems used currently in routine practice.
The WS is a promising tool for risk stratification of surgical patients. It is already collected routinely by nursing staff throughout hospitals in the UK and would therefore be easy to implement. However, further large prospective studies are required in order to validate these findings prior to its establishment for this role in everyday surgical practice.
Waterlow 评分（WS）常用于临床实践中评估压疮发生风险。最近的研究还表明其可用于术前风险分层。本系统评价的主要目的是评估 WS 在预测手术患者发病率和死亡率方面的现有证据。
根据 PRISMA 和 SWiM 指南进行了系统评价。在 MEDLINE 和 EMBASE 数据库上进行了搜索策略。使用纽卡斯尔-渥太华量表评估质量。
共确定了 72 篇论文，其中 7 篇符合全文审查标准，4 篇纳入分析。所有研究均为队列研究，发表于 2013 年至 2016 年之间，共纳入 505 例手术患者。研究包括普外科、血管外科、移植外科和骨科手术。高 WS 与发病率和死亡率增加以及需要重症监护病房入院和住院时间延长有统计学显著关联。此外，与目前常规实践中使用的 P-POSSUM 和 ASA 评分系统相比，该评分系统是一种更准确的预测指标。
WS 是一种有前途的手术患者风险分层工具。它已经在英国的医院由护理人员常规收集，因此易于实施。但是，需要进一步的大型前瞻性研究来验证这些发现，然后才能在日常外科实践中确立其作用。
