Tourtual D M, Riesenberg L A, Korutz C J, Semo A H, Asef A, Talati K, Gill R D
United Health Services Hospitals, Johnson City, NY, USA.
Ostomy Wound Manage. 1997 Oct;43(9):24-8, 30, 32-4 passim.
The purpose of this study was to evaluate predictors of hospital acquired heel pressure ulcers. A prospective cohort study of hospitalized patients was conducted (N = 291). Subjects were enrolled by one team and followed by another team that was blind to initial assessment information. Initial assessment included demographics, Braden scale, and other variables found in the first study to be statistically significant. Ongoing evaluation involved heel assessment only. Univariate analysis yielded 15 statistically significant variables. Using multivariate logistic regression, subject's with a potential problem on the Braden Friction and Shear item (p = 0.01) and who were more frequently moist on the Braden Moisture item (p = 0.007) were more likely to develop heel ulcers (chi-square 30.52, df 3, p = 0.00001). Receiver Operator Characteristic (ROC) curves were plotted for the Braden scale and multiple other scoring systems. ROC curves were virtually identical using all new scoring systems as compared to the original Braden scale. No new scoring system was identified that led to a clinically significant improvement in sensitivity/specificity over the total Braden scale. While not perfect, the Braden scale may currently be the best predictive tool for heel pressure ulcer development.
本研究的目的是评估医院获得性足跟压疮的预测因素。对住院患者进行了一项前瞻性队列研究（N = 291）。受试者由一个团队招募，由另一个对初始评估信息不知情的团队进行随访。初始评估包括人口统计学、Braden量表以及在第一项研究中发现具有统计学意义的其他变量。持续评估仅涉及足跟评估。单因素分析得出15个具有统计学意义的变量。使用多因素逻辑回归分析，Braden摩擦力与剪切力项目存在潜在问题（p = 0.01）且Braden潮湿项目更常出现潮湿情况（p = 0.007）的受试者更有可能发生足跟溃疡（卡方值30.52，自由度3，p = 0.00001）。绘制了Braden量表和其他多个评分系统的受试者工作特征（ROC）曲线。与原始Braden量表相比，使用所有新评分系统绘制的ROC曲线几乎相同。未发现有新的评分系统在敏感性/特异性方面比整个Braden量表有临床上的显著改善。虽然并不完美，但Braden量表目前可能是预测足跟压疮发生的最佳工具。
