Comparison of the predictive validity among pressure ulcer risk assessment scales for surgical ICU patients

Abstract

Objective: To compare the predictive validity of three pressure ulcer risk scales: the Braden scale; the Song and Choi scale; and the Cubbin and Jackson scale and to choose the most appropriate calculator for predicting pressure ulcer risk in the Surgical Intensive Care Unit (SICU) in South Korea.

Design: Non‑experimental prospective study.

Setting: A 1,053 bed tertiary educational hospital in South Korea.

Subjects:219 SICU patients at a hospital in South Korea from 1 November 2006 to 31 March 2007.

Main outcome measures: Sensitivity, specificity, predictive value positive and predictive value negative and the AUC (area under the curve) of the ROC (receiver operating characteristic) curve of the three pressure ulcer risk assessment scales.

Results: Based on the cut‑off points presented in this study, the sensitivity, specificity, predictive value positive and predictive value negative were as follows: the Braden scale (cut‑off 14) had values of 92.5%, 69.8%, 40.6%, 97.6%, respectively; the Song and Choi scale (cut‑off 21) had 95.0%, 69.2%, 40.8%, 98.4%, respectively; the Cubbin and Jackson scale (cut‑off 28) had 95.0%, 81.5%, 53.5%, 98.6%, respectively. The AUCs of the ROC curve were 0.881 for the Braden, 0.890 for the Song and Choi and 0.902 for the Cubbin and Jackson.

Conclusions: The results of this research sample showed that the Cubbin and Jackson scale was most effective in predicting pressure ulcer risk compared to the other two scales in the SICU.