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Zhang Y, Zhuang Y, Shen J, Chen X, Wen Q, Jiang Q, Lao Y, et al.
Intensive & critical care nursing. Date of publication 2021 Jun 1;volume 64():103009.
1. Intensive Crit Care Nurs. 2021 Jun;64:103009. doi: 10.1016/j.iccn.2020.103009. Epub 2021 Feb 25. Value of pressure injury assessment scales for patients in the intensive care unit: Systematic review and diagnostic test accuracy meta-analysis. Zhang Y(1), Zhuang Y(2), Shen J(3), Chen X(4), Wen Q(5), Jiang Q(5), Lao Y(4). Author information: (1)Department of Intensive Care Unit, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou 311500, China; School of Medicine, Huzhou University, Huzhou Central Hospital, No. 759, East 2nd Road, Huzhou 313000, China. (2)Department of Nursing, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou 311500, China. (3)Branch Center of Chinese Cochrane Center, Huzhou University, Huzhou 313000, China; School of Medicine, Huzhou University, Huzhou Central Hospital, No. 759, East 2nd Road, Huzhou 313000, China. Electronic address: sjiantong@163.com. (4)Department of Intensive Care Unit, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou 311500, China. (5)School of Medicine, Huzhou University, Huzhou Central Hospital, No. 759, East 2nd Road, Huzhou 313000, China. OBJECTIVES: To review and examine the evidence of the value of pressure injury risk assessment scales in intensive care patients. RESEARCH METHODOLOGY: We searched MEDLINE, Embase, CINAHL, Web of Science, the Cochrane Library, China Biomedical Literature Service System, VIP Database and CNIK from inception to February 2019. Two reviewers independently assessed articles' eligibility and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-II (QUADAS-2). We used a hierarchical summary receiver operating characteristics (HSROC) model to conduct the meta-analysis of diagnostic accuracy. RESULT: Twenty-four studies were included, involving 16 scales and 15,199 patients in intensive care settings. Results indicated that the top four risk assessment scales were the Cubbin & Jackson Index (SEN = 0.84, SPE = 0.84, AUC = 0.90), the EVRUCI scale (SEN = 0.84, SPE = 0.68, AUC = 0.82), the Braden scale (SEN = 0.78, SPE = 0.61, AUC = 0.78), the Waterlow scale (SEN = 0.63, SPE = 0.46, AUC = 0.56). The Norton scale and the other eleven scales were tested in less than two studies and need to be further researched. CONCLUSION: The Braden scale, most frequently used in hospitals, is not the best risk assessment tool for critically ill patients. The Cubbin & Jackson Index has good diagnostic test accuracy. However, low quality of evidence and important heterogeneity were observed. Copyright © 2020 Elsevier Ltd. All rights reserved. DOI: 10.1016/j.iccn.2020.103009 PMID: 33640238 [Indexed for MEDLINE]
Appears in following Topics:
Pressure Ulcers/Injuries - Prevention