Predicting the Risk for Hospital-Acquired Pressure Ulcers in Critical Care Patients

Abstract

Background: Assessments of risk for pressure ulcers in critical care patients may not include important predictors.

Objective: To construct risk-prediction models of hospital-acquired pressure ulcers in intensive care patients and compare the models' predictive validities with validity of the Braden Scale.

Methods: Data were collected retrospectively on patients admitted to intensive care from October 2011 through October 2013. Logistic regression and decision trees were used to construct the risk-prediction models. Predictive validity was measured by using sensitivity, specificity, positive and negative predictive values, and area under the curve.

Results: With logistic regression analysis, 6 factors were significant independent predictors. With the decision tree, 4 types of high-risk populations were identified. Predictive validity of Braden Scale scores was lower than the validities of the logistic regression and the decision tree models.

Conclusion: Risk for hospital-acquired pressure ulcers is overpredicted with the Braden Scale, with low specificity and low positive predictive value.