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Study on the applicability and optimal cut-off of Braden Scale in the diagnosis of pressure injury in the elderly based on multicenter study data
JIANG Qixia, LIU Guozhen, ZHU Yuling, LI Yumei, ZHAN Yingying, YU Xiujuan, JIE Yijie, WANG Jing, BAI Yuxuan
Chinese Journal of Nursing    2023, 58 (4): 440-445.   DOI: 10.3761/j.issn.0254-1769.2023.04.008
Abstract830)   HTML1)    PDF (712KB)(22)       Save

Objective To analyze the applicability and the optimal cut-off of Braden Scale for the diagnosis of pressure injury in the elderly through the data of multicenter cross-sectional study of pressure injury in the elderly in China,so as to provide bases for the correct use of Braden scale in clinical practice. Methods 1067 trained and qualified nurses from 52 different medical institutions across the country were recruited in a group of 2. They included the inpatients over 60 years old by purpose sampling method,examined the skin and relevant data of patients,and evaluated whether there was pressure injury and its stage,and used the Braden Scale to predict the risk of pressure injury. The statistical software was used to analyze the epidemic characteristics of pressure injury in the elderly,and the area under the working characteristic curve(AUC),sensitivity,specificity and Yoden index of those with pressure injury were predicted and diagnosed by the Braden Scale. Results In the effective data of 3 3769 cases,the total prevalence of pressure injury was 3.12%(n=1 054),of which the incidence of hospital acquired pressure injury was 0.79%(n=267). Hierarchical analysis showed that the AUC predicted by the Braden Scale for the diagnosis of pressure injury in elderly patients of different ages,gender,races and medical institutions was 0.85~0.96,and the sensitivity and specificity were 0.83~0.96 and 0.71~0.86,respectively. The AUC of the 6 cut-off values of total score≤15,≤16,≤17,≤18,≤19 and ≤20 points was 0.67~0.82; the sensitivity and specificity were 0.67~0.84 and 0.54~0.68,respectively; the Youden index was 0.25~0.49. The Youden index and AUC of ≤20 points was the largest. Conclusion Braden Scale is suitable for elderly patients of different ages,gender,race and medical institutions to assess and predict the risk of pressure injury. The total score of≤20 points can be used as the best cut-off,which can improve the prediction efficiency.

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Analysis on the prevalence and risk factors of skin injuries in the elderly in 50 hospitals in China
JIANG Qixia, TANG Yongli, HONG Yanyan, KUANG Dan, WANG Jing, ZHAN Yingying, PAN Yingchun, GAO Yanhong, HAO Jingping, CHEN Rui, LIU Haiyan, YU Ping, CAI Yunmin, HUANG Ling, WANG Zujing
Chinese Journal of Nursing    2022, 57 (9): 1105-1112.   DOI: 10.3761/j.issn.0254-1769.2022.09.012
Abstract706)   HTML8)    PDF (978KB)(20)       Save

Objective To analyze the prevalence and risk factors of 3 types of skin injuries in the elderly through multicenter cross-sectional survey,so as to provide bases for formulating prevention strategies for skin injuries in the elderly. Methods On March 31,2021,1 067 nurses from 50 hospitals in 16 provinces,2 autonomous regions and 2 municipalities included inpatients over 60 years old and inspected their skin from head to toes to identify pressure injury(PI),incontinence-associated dermatitis(IAD) and skin tear(ST),and meanwhile collected demographic,healthcare condition and PI risk assessment data. Statistical software was used for descriptive analysis,Pearson correlation analysis and logistic regression analysis. Results Totally,14 470 cases were obtained. The average age was(73.35±8.90) years old. The total prevalence of skin injuries was 6.69%,and the prevalence of PI,IAD and ST was 3.91%,1.89% and 0.89%,respectively. Logistic regression analysis showed that the risk of PI,inability of self-care,hypoproteinemia and anemia,comorbidity over 2 chronic diseases and ≥70 years old were the independent risk factors of PI in the elderly. The risk of PI,inability of self-care,hypoproteinemia,comorbidity over 2 chronic diseases,length of hospital stay≥8 days and the age of over 80 years were the independent risk factors of IAD in the elderly. The risk of PI and hypoproteinemia were independent risk factors of ST in the elderly. Conclusion Skin injuries of the hospitalized elderly are the result of multiple factors,while PI and IAD are the most typical ones,and the risk factors of different types of skin injuries are also different. When formulating prevention strategies,we should not only pay attention to the independent role of risk factors,but also consider the combined role of risk factors,take comprehensive preventive measures to improve the prevention effect.

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