Huang C, Ma Y, Wang C, Jiang M, Yuet Foon L, Lv L, Han L, et al.
Nursing open. Date of publication 2021 Sep 1;volume 8(5):2194-2207.
1. Nurs Open. 2021 Sep;8(5):2194-2207. doi: 10.1002/nop2.792. Epub 2021 Feb 25.
Predictive validity of the braden scale for pressure injury risk assessment in
adults: A systematic review and meta-analysis.
Huang C(1)(2), Ma Y(1)(3), Wang C(4), Jiang M(1), Yuet Foon L(1), Lv L(1)(4), Han
L(1)(4).
Author information:
(1)Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou,
China.
(2)Department of Endocrinology, The First Hospital of Lanzhou University,
Lanzhou, China.
(3)The First Clinical Medical College, Lanzhou University, Lanzhou, China.
(4)Nursing Department, Gansu Provincial Hospital, Lanzhou, China.
AIM: Pressure injuries are common adverse events in clinical practice, affecting
the well-being of patients and causing considerable financial burden to
healthcare systems. It is therefore essential to use reliable assessment tools to
identify pressure injuries for early prevention. The Braden Scale is a widely
used tool to assess pressure injury risk, but the literature is currently lacking
in determining its accuracy. This study aimed to evaluate the accuracy of the
Braden Scale in assessing pressure injury risk.
DESIGN: Systematic review and meta-analysis.
METHODS: Articles published between 1973-2020 from periodicals indexed in the
PubMed, EMBASE, CINAHL, Web of Science and the Cochrane Library were selected.
Two reviewers independently selected the relevant studies for inclusion. Data
were analysed by the STATA 15.0 and the RevMan 5.3 software.
RESULTS: In total, 60 studies involving 49,326 individuals were eligible for this
meta-analysis. The pooled SEN, SPE, PLR, NLR, DOR and AUC were 0.78 (95% CI: 0.74
to 0.82), 0.72 (95% CI: 0.66 to 0.78), 2.80 (95% CI: 2.30 to 3.50), 0.30 (95% CI:
0.26 to 0.35), 9.00 (95% CI: 7.00 to 13.00) and 0.82 (95% CI: 0.79 to 0.85),
respectively. Subgroup analyses indicated that the AUC was higher for prospective
design (0.84, 95% CI: 0.81 to 0.87), mean age <60 years (0.87, 95% CI: 0.84 to
0.90), hospital (0.82, 95% CI: 0.79 to 0.86) and Caucasian population (0.86, 95%
CI: 0.82 to 0.88). In addition, 18 was found to be the optimal cut-off value.
CONCLUSION: The evidence indicated that the Braden Scale had a moderate
predictive validity. It was more suitable for mean age <60 years, hospitalized
patients and the Caucasian population, and the cut-off value of 18 might be used
for the risk assessment of pressure injuries in clinical practice. However, due
to the different cut-off values used among included studies, the results had a
significant heterogeneity. Future studies should explore the optimal cut-off
value in the same clinical environment.
© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.
DOI: 10.1002/nop2.792
PMCID: PMC8363405
PMID: 33630407 [Indexed for MEDLINE]
