Risk Assessment Tool for Pressure Ulcer Development in Indian Surgical Wards

The aims of this paper were to compare the predictive validity of three pressure ulcer (PU) risk scales—the Norton scale, the Braden scale, and the Waterlow scale—and to choose the most appropriate calculator for predicting PU risk in surgical wards of India. This is an observational prospective coh...

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Bibliographic Details
Published in:Indian journal of surgery 2015-06, Vol.77 (3), p.206-212
Main Authors: Kumari, Sushma, Sharma, Deborshi, Rana, Anshika, Pathak, Reetesh, Lal, Romesh, Kumar, Ajay, Biswal, U C
Format: Article
Language:English
Subjects:
Cardiac Surgery
Decubitus ulcer
Medicine
Medicine & Public Health
Neurosurgery
Original
Original Article
Pediatric Surgery
Plastic Surgery
Pressure ulcers
Prognosis
Risk assessment
Surgery
Thoracic Surgery
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Summary:The aims of this paper were to compare the predictive validity of three pressure ulcer (PU) risk scales—the Norton scale, the Braden scale, and the Waterlow scale—and to choose the most appropriate calculator for predicting PU risk in surgical wards of India. This is an observational prospective cohort study in a tertiary educational hospital in New Delhi among 100 surgical ward patients from April to July 2011. The main outcomes measured included sensitivity, specificity, positive predictive value (PVP) and negative predictive value (PVN), and the area under the curve of the receiver operating characteristic (ROC) curve of the three PU risk assessment scales. Based on the cutoff points found most appropriate in this study, the sensitivity, specificity, PVP, and PVN were as follows: the Norton scale (cutoff, 16) had the values of 95.6, 93.5, 44.8, and 98.6, respectively; the Braden scale (cutoff, 17) had values of 100, 89.6, 42.5, and 100, respectively; and the Waterlow scale (cutoff, 11) had 91.3, 84.4, 38.8, and 97, respectively. According to the ROC curve, the Norton scale is the most appropriate tool. Factors such as physical condition, activity, mobility, body mass index (BMI), nutrition, friction, and shear are extremely significant in determining risk of PU development ( p  
ISSN:0972-2068
0973-9793
DOI:10.1007/s12262-012-0779-y