Epidemiological characteristics of pressure injury and the predictive validity of Braden scale among the older hospitalized patients: A cross-sectional study

J Clin Nurs. 2023 Nov;32(21-22):7802-7811. doi: 10.1111/jocn.16858. Epub 2023 Aug 29.

Abstract

Aims and objectives: To investigate the epidemiological characteristics of pressure injury (PI) in older inpatients and predictive validity of the Braden scale.

Design: Cross-sectional study.

Methods: Conducted in a 2600-bed tertiary hospital in Northwestern China from January to June 2022, the study included older patients (≥60 years). The Braden scale was used for the risk assessment of PI, and the epidemiological characteristics of PI were observed. The contributing factors of PI in older inpatients were examined using univariate and multiple or multivariable logistic regression analysis. The predictive validity and optimal cut-off value were assessed using receiver operating curve (ROC).

Results: The study included 13,064 older patients, with a PI incidence of 0.20%, with the highest incidence (0.95%) in those aged ≥80. Age, BMI, Braden score and length of hospital stay were related to PI occurrence. The Braden scale showed an AUC of 0.905 for predicting PI in older inpatients, with a sensitivity of 84.6% and specificity of 86.4%. The optimal cut-off value of 19 yielded the best predictive performance with a Yoden index of 0.710.

Conclusion: PI is most likely to occur in older inpatients with older age, longer hospital stay, lower BMI and Braden score. The Braden scale demonstrated good suitability for predicting PI risk in this population, with an optimal cut-off value of 19 showing improved predictive accuracy.

Patient or public contribution: Throughout the investigation, patients or family members cooperated to complete all data investigation and evaluation, and nurses assisted in PI risk assessment, skin evaluation and other work.

Keywords: Braden scale; older inpatients; predictive validity; pressure injury.