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比较Braden评分与急性生理与慢性健康状况评分系统(APACHE)预测三级护理重症监护病房压疮发生情况的效果

Comparison of Braden Score vs APACHE to Predict Occurrence of Bed Sores in a Tertiary Care ICU.

作者信息

Maqbool Khuram, Chauhan Munish, Dewan Sandeep

机构信息

Department of Critical Care Medicine, Fortis Memorial Research Institute, Gurugram, Haryana, India.

出版信息

Indian J Crit Care Med. 2025 Feb;29(2):164-169. doi: 10.5005/jp-journals-10071-24911. Epub 2025 Jan 31.

Abstract

INTRODUCTION

Pressure sores, or bedsores, pose a challenge in intensive care unit (ICU) care due to patients' immobility and compromised circulation. This study explores the effectiveness of the Braden Scale and acute physiology and chronic health evaluation II (APACHE II) in predicting pressure sore occurrences.

MATERIALS AND METHODS

Conducted over a year in an Indian ICU, this observational study assessed the predictive capability of both scores. Participants (≥18 years) underwent Braden and APACHE II assessments upon admission, with daily monitoring for pressure sore development. Statistical analysis compared scores and ulcer occurrences.

RESULTS

Older patients, particularly males, showed a higher tendency for ICU admission. 20.3% had pressure ulcers, significantly correlating with lower Braden and higher APACHE II scores. Acute physiology and chronic health evaluation II showed superior efficiency in predicting ulcers.

DISCUSSION

While Braden scores' variability was less in ICU patients, APACHE II scores reflected acute illness severity, strongly correlating with ulcer incidence. The study advocates for a combined utilization of both scores for tailored interventions.

CONCLUSION

Acute physiology and chronic health evaluation II demonstrated better efficiency in predicting pressure ulcers, while the Braden score remains valuable for focused assessments. The study highlights the importance of considering age, gender, acute health status, and localized risk factors in ICU pressure ulcer assessment.

FUTURE DIRECTIONS

Further research might explore integrated scoring systems or protocols combining the strengths of both scores for more precise risk assessment in ICU settings.

HOW TO CITE THIS ARTICLE

Maqbool K, Chauhan M, Dewan S. Comparison of Braden Score vs APACHE to Predict Occurrence of Bed Sores in a Tertiary Care ICU. Indian J Crit Care Med 2025;29(2):164-169.

摘要

引言

由于患者行动不便且血液循环受损,压疮(又称褥疮)在重症监护病房(ICU)护理中构成了一项挑战。本研究探讨了Braden量表和急性生理学与慢性健康状况评估II(APACHE II)在预测压疮发生方面的有效性。

材料与方法

这项观察性研究在印度一家ICU进行了一年,评估了这两种评分的预测能力。参与者(≥18岁)在入院时接受Braden和APACHE II评估,并每日监测压疮的发生情况。统计分析比较了评分与溃疡发生情况。

结果

老年患者,尤其是男性,入住ICU的倾向较高。20.3%的患者发生了压疮,与较低的Braden评分和较高的APACHE II评分显著相关。急性生理学与慢性健康状况评估II在预测溃疡方面显示出更高的效率。

讨论

虽然Braden评分在ICU患者中的变异性较小,但APACHE II评分反映了急性疾病的严重程度,与溃疡发生率密切相关。该研究主张联合使用这两种评分以进行针对性干预。

结论

急性生理学与慢性健康状况评估II在预测压疮方面显示出更高的效率,而Braden评分在重点评估中仍具有价值。该研究强调了在ICU压疮评估中考虑年龄、性别、急性健康状况和局部危险因素的重要性。

未来方向

进一步的研究可能会探索整合评分系统或方案,结合两种评分的优势,以便在ICU环境中进行更精确的风险评估。

如何引用本文

Maqbool K, Chauhan M, Dewan S. Comparison of Braden Score vs APACHE to Predict Occurrence of Bed Sores in a Tertiary Care ICU. Indian J Crit Care Med 2025;29(2):164-169.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/204f/11915442/82b402762ed4/ijccm-29-164-g001.jpg

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