Complementing Braden scale for pressure ulcer risk with clinical and demographic-related factors in a large cohort of hospitalized Italian patients

Lorenzo Giovannoni; Yari Longobucco; Paolo Iovino; Chiara Barbetti; Silvia Becattini; Daniela Bonanni; Francesco Cordelli; Matteo Cosci; Cristiana Del Perugia; Rachele Flego; Domenica Giannuzzi; Barbara Guasti; Sabrina Roberta Iannone; Riccardo Latini; Consuelo Macchitella; Francesca Piccardi; Elia Prisco; Tiziana Pucci; Manola Tricca; Laura Rasero

doi:10.1016/j.jtv.2024.03.005

Complementing Braden scale for pressure ulcer risk with clinical and demographic-related factors in a large cohort of hospitalized Italian patients

J Tissue Viability. 2024 Mar 2:S0965-206X(24)00030-5. doi: 10.1016/j.jtv.2024.03.005. Online ahead of print.

Authors

Lorenzo Giovannoni¹, Yari Longobucco², Paolo Iovino³, Chiara Barbetti⁴, Silvia Becattini⁴, Daniela Bonanni⁴, Francesco Cordelli⁴, Matteo Cosci⁴, Cristiana Del Perugia⁴, Rachele Flego⁴, Domenica Giannuzzi⁴, Barbara Guasti⁴, Sabrina Roberta Iannone⁴, Riccardo Latini⁴, Consuelo Macchitella⁴, Francesca Piccardi⁴, Elia Prisco⁴, Tiziana Pucci⁴, Manola Tricca⁴, Laura Rasero²

Affiliations

¹ Research and Development of Clinical Practice Unit, Careggi University Hospital, Florence, Italy; Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy.
² Research and Development of Clinical Practice Unit, Careggi University Hospital, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy.
³ Department of Health Sciences, University of Florence, Florence, Italy. Electronic address: paolo.iovino@unifi.it.
⁴ Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy.

PMID: 38458956
DOI: 10.1016/j.jtv.2024.03.005

Abstract

Aims: To determine the prevalence, risk, and determinants of pressure ulcer risk in a large cohort of hospitalized patients.

Design: A prospective cross-sectional study with data collection in January 2023.

Methods: Registered nurses collected data from 798 patients admitted to 27 health care units of an Italian hospital. The pressure ulcer risk was assessed using the Braden scale. The presence of comorbidities was collected from clinical reports. Obesity was assessed according to international indicators (Body Mass Index). The receiver operating characteristic (ROC) curve was used to estimate the sensitivity and specificity of different Braden scores for identifying participants with pressure ulcers.

Results: The prevalence of pressure ulcers was 9.5%, and 57.4% of the sample were at risk of developing pressure ulcers. The area under the ROC curve was 0.88. The best sensitivity and specificity were found for a Braden cutoff score of 15.5 (sensibility = 0.76; specificity = 0.85). The determinants of lower Braden scores were older age (p < 0.001), comorbidities (p < 0.001), wounds of other nature (p = 0.001), urinary incontinence (p < 0.001), fecal incontinence (p < 0.001), and urinary catheterization (p < 0.001).

Conclusion: Several demographic factors and specific clinical indicators have been identified as determinants of the risk of developing pressure ulcers, which are easily ascertainable by healthcare providers; thus, they may routinely complement the Braden Scale in the assessment of pressure ulcer risk in order to reinforce and accelerate clinical judgment.

Keywords: Braden scale; Cross-sectional studies; Pressure ulcer; Prevalence; Risk assessment; Risk factors.