Predicting Pressure Ulcer Risk with the Braden Q Scale in Chinese Pediatric Patients in ICU

Objective:The purpose of this study was to:(1) observe the value of the score of Braden Q scale in predicting pressure ulcers in pediatric Intensive Care Unit(ICU) patients in China,(2)determine the critical cutoff point for classifying patient risk,and(3) describe the pressure ulcer incidence.Methods:A prospective cohort descriptive study with a convenience sample of 198 patients bedridden for at least 24 hours without pre-existing pressure ulcers enrolled from a pediatric intensive care unit(PICU).The Braden Q score and skin assessment were independently rated,and data collectors were blinded to the other measures.Patients were observed for up to 3 times per week for 2 weeks and once a week thereafter until PICU discharge.Results:Fourteen patients(7.1%) developed pressure ulcers;12(85.7%) were Stage Ⅰ pressure ulcers,2(14.3%) were Stage Ⅱ,and there were no Stage Ⅲ or Ⅳ pressure ulcers.Most pressure ulcers(64.3%) were present at the first observation.The Braden Q Scale has an overall cumulative variance contribution rate of 69.599%.Using Stage Ⅰ+ pressure ulcer data obtained during the first observation,a Receiver Operator Characteristic(ROC) curve for each possible score of the Braden Q Scale was constructed.The area under the curve(AUC) was 0.57,and the95%confidence interval was 0.50-0.62.At a cutoff score of 19,the sensitivity was 0.71,and the specificity was 0.53.The AUC of each item of the Braden Q Scale was 0.543-0.612.Conclusions:PICU patients are susceptible to pressure ulcers.The value of the Braden Q Scale in the studied pediatric population was relatively poor,and it should be optimized before it is used in Chinese pediatric patients.