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Pressure Injury Prediction Tool Lacking for Severe COVID-19 Patients

Risk factors for device-related pressure injury include fragile skin and prone positioning during mechanical ventilatory support

FRIDAY, Sept. 9, 2022 (HealthDay News) — Critically ill patients with COVID-19 have a high risk for hospital-acquired pressure injury, with the Braden Scale providing only poor-to-fair predictive discrimination, according to a study recently published in AACN Advanced Critical Care.

Jenny Alderden, Ph.D., from the Boise State University School of Nursing in Idaho, and colleagues compared Braden Scale predictive validity between patients with and without COVID-19 and examined risk factors for device-related pressure injury. The study sample included 1,920 patients, 407 of whom had COVID-19.

The researchers found that among the patients with COVID-19, 120 patients (29 percent) developed at least one hospital-acquired pressure injury; of those, device-related pressure injury developed in 55 patients (46 percent). The Braden Scale score area under the receiver operating characteristic curve was 0.72 and 0.71 in patients without and with COVID-19, respectively, indicating fair-to-poor discrimination. Risk factors for device-related pressure injury in patients with COVID-19 included fragile skin and prone positioning during mechanical ventilatory support.

“Results from this study show that the Braden Scale lacked predictive validity in patients in the intensive care unit with and without COVID-19 because of low specificity,” the authors write. “Clinicians may consider incorporating factors not included in the Braden Scale (e.g., oxygenation and perfusion) in routine risk assessment and should maintain vigilance in their efforts to protect patients with COVID-19 from device-related pressure injury.”

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