Aloweni F, Ang SY, Fook-Chong S, Agus N, Yong P, Goh MM, Tucker-Kellogg L, Soh RC, et al.
International wound journal. Date of publication 2018 Oct 5;volume ():.
1. Int Wound J. 2018 Oct 5. doi: 10.1111/iwj.13007. [Epub ahead of print]
A prediction tool for hospital-acquired pressure ulcers among surgical patients:
Surgical pressure ulcer risk score.
Aloweni F(1), Ang SY(1), Fook-Chong S(2), Agus N(1), Yong P(1), Goh MM(1),
Tucker-Kellogg L(3), Soh RC(4).
Author information:
(1)Nursing Division, Singapore General Hospital (SGH), Singapore, Singapore.
(2)Health Services Research Unit, SGH, Singapore, Singapore.
(3)Cancer & Stem Cell Biology, and Centre for Computational Biology Duke-NUS
Medical School, Singapore, Singapore.
(4)Department of Anaesthesia, SGH, Singapore, Singapore.
Surgical patients are prone to developing hospital-acquired pressure ulcers
(HAPU). Therefore, a better prediction tool is needed to predict risk using
preoperative data. This study aimed to determine, from previously published HAPU
risk factors, which factors are significant among our surgical population and to
develop a prediction tool that identifies pressure ulcer risk before the
operation. A literature review was first performed to elicit all the published
HAPU risk factors before conducting a retrospective case-control study using
medical records. The known HAPU risks were compared between patients with HAPU
and without HAPU who underwent operations during the same period (July
2015-December 2016). A total of 80 HAPU cases and 189 controls were analysed.
Multivariate logistic regression analyses identified eight significant risk
factors: age ≥ 75 years, female gender, American Society of Anaesthesiologists ≥
3, body mass index < 23, preoperative Braden score ≤ 14, anaemia, respiratory
disease, and hypertension. The model had bootstrap-corrected c-statistic 0.78
indicating good discrimination. A cut-off score of ≥6 is strongly predictive,
with a positive predictive value of 73.2% (confidence interval [CI]: 59.7%-84.2%)
and a negative predictive value of 80.7% (CI: 74.3%-86.1%). SPURS contributes to
the preoperative identification of pressure ulcer risk that could help nurses
implement preventive measures earlier.
© 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
DOI: 10.1111/iwj.13007
PMID: 30289624
