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]
