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Gerokomos

Print version ISSN 1134-928X

Abstract

GARCIA-FERNANDEZ, Francisco P.; PANCORBO-HIDALGO, Pedro L.; SOLDEVILLA AGREDA, José Javier  and  RODRIGUEZ TORRES, Mª del C.. Risk assessment scales for pressure ulcer in intensive care units: a systematic review with metaanalysis. Gerokomos [online]. 2013, vol.24, n.2, pp.82-89. ISSN 1134-928X.  http://dx.doi.org/10.4321/S1134-928X2013000200007.

Aims: To identify risk assessment scales for pressure ulcers that have been used in the critical care units. Determine which of them have been validated according to the criteria of validity, predictive capacity and reliability, developing, where possible, aggregate indicators. Methods: Systematic review of the clinical literature with meta-analysis. The main international health science databases were searched for prospective studies on the validity and/or predictive capacity of pressure ulcers risk assessment scales published between 1962 and 2009 in any language and with a loss to follow-up of less than 25%. We excluded the grey literature, reviews, and retrospective and cross-sectional studies. The methodological quality of the studies was assessed according to the guidelines of the Critical Appraisal Skills Program. The indicators analyzed were validity, effect size (RR) and reliability. When two or more valid original studies were found, a meta-analysis was conducted using the random-effect model followed by a sensitivity analysis. Results: We have identified a total of 255 articles identified 16 risk assessment scales designed specifically for UCI. There are 26 studies that measure the validity of the same. Only three scales have more of a validation study (NM Bienstein, Cubbin-Jackson, Jackson-Cubbin). Four general scales have also been validated in ICU (Braden, Norton, BM Choi Song-and Waterlow). Waterlow and NM Bienstein are not valid for low sensitivity. Cubbin-Jackson, Jackson-Cubbin and Norton have very similar predictive validity data, but with very small sample. Braden scale is best tested in the ICU, with appropriate parameters and predictive validity. Conclusions: We recommend the use of the Braden Scale to assess the risk of developing pressure ulcers in critical care units. Other scales as Cubbin-Jackson, Jackson-Cubing, Norton or BM Choi-Song can be useful, but need to be tested in a larger number of patients.

Keywords : Pressure ulcer; risk assessment scales; intensive care units; systematic review; metaanalysis.

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