Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2021; 9(35): 10956-10968
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10956
Predictive risk scales for development of pressure ulcers in pediatric patients admitted to general ward and intensive care unit
Wen-Jun Luo, Xue-Zhen Zhou, Jia-Ying Lei, Ying Xu, Rui-Hua Huang
Wen-Jun Luo, Xue-Zhen Zhou, Jia-Ying Lei, Ying Xu, Rui-Hua Huang, Sun Yat-sen Memorial Hospital, Guangzhou 510235, Guangdong Province, China
Author contributions: Luo WJ and Zhou XZ contributed to the study conception and design; Luo WJ collected the data; Huang RH contributed to the data analysis and interpretation; Luo WJ drafted the article; Zhou XZ and Huang RH contributed to the critical revision of the article.
Institutional review board statement: The study was approved by the ethics committee of Sun Yat-sen Memorial hospital [approval number: 2017(23)]
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Zhen Zhou, MS, Chief Nurse, Sun Yat-sen Memorial Hospital, No. 107 Yanjiang West Road, Yuexiu District, Guangzhou 510235, Guangdong Province, China. 956287439@qq.com
Received: June 19, 2021
Peer-review started: June 19, 2021
First decision: July 16, 2021
Revised: August 26, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: December 16, 2021
Processing time: 174 Days and 3.7 Hours
Abstract
BACKGROUND

More than ten special scales are available to predict the risk of pressure ulcers in children. However, the performances of those scales have not yet been compared in China.

AIM

To compare the Waterlow, Braden Q, and Glamorgan scales, and identify more suitable pressure ulcer evaluation scale for the pediatric intensive care unit (PICU).

METHODS

Trained nurses used the Waterlow, Braden Q, and Glamorgan scales to assess pediatric patients at Sun Yat-sen Memorial Hospital (China) within 24 h of admission from May 2017 to December 2020 in two stages. Skin examination was carried out to identify pressure ulcers every 3 d for 3 wk.

RESULTS

The incidence of pressure ulcers was 3/28 (10.7%) in the PICU and 5/314 (1.6%) in the general pediatric ward. For children in the general ward, the Waterlow, Braden Q, and Glamorgan scales had comparable area under the operating characteristic curve (AUC) of 0.870, 0.924, and 0.923, respectively, and optimal cut-off values of 14, 14, and 29 points. For PICU, the Waterlow, Braden Q, and Glamorgan scales had slightly lower AUC of 0.833, 0.733, and 0.800, respectively, and optimal cut-off values of 13, 16, and 27 points. Braden Q demonstrated a satisfactory specificity, and during the second stage of the study for PICU patients, the AUC of the Braden Q scale was 0.810, with an optimal cut-off value of 18.35 points.

CONCLUSION

The Waterlow, Braden Q, and Glamorgan scales have comparable performance, while the Braden Q scale demonstrates a better specificity and can be successfully used by pediatric nurses to identify patients at high risk of pressure ulcers in PICU.

Keywords: Pressure ulcer; Risk assessment; Children; Intensive care unit

Core Tip: The present study explored and analyzed commonly used Waterlow, Braden Q, and Glamorgan scales for the predictive diagnostic value of pressure ulcers in pediatric patients. In this study, the Braden Q scale had the highest specificity, which might serve as a valuable tool to predict pressure ulcers in pediatric intensive care unit (PICU) patients. The Waterlow, Braden Q, and Glamorgan scales have comparable performance, while the Braden Q scale demonstrated a better specificity and can be successfully used by pediatric nurses to identify patients at high risk of pressure ulcers in PICU.