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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
Appears in following Topics:
Pressure Ulcers/Injuries - Introduction and Assessment
How to Assess a Patient with Chronic Wounds