超声技术联合Braden量表预测严重多发伤患者压力性损伤发生风险的价值

The value of ultrasound technology combined with the Braden scale in predicting the risk of pressure injuries in patients with severe multiple injuries

目的研究超声技术评分联合Braden量表预测严重多发伤患者压力性损伤发生风险的价值。方法根据纳入和排除标准,入组2022年12月至2023年12月在重庆大学附属中心医院住院的216例患者。收集每例患者的Braden量表和体表超声检测结果,分别统计Braden量表、超声技术评分、Braden量表联合超声技术评分的受试者操作特征(ROC)曲线,计算曲线下面积(AUC)、灵敏度、特异度及其他预测指标,分析和比较联合手段预测的临床价值。结果严重多发伤患者压力性损伤发生率为24.5%。Braden量表对严重多发伤患者压力性损伤发生风险的AUC为0.602[95%可信区间(95%CI)0.507~0.696,P=0.026]。以Braden量表评分12分为切点时,诊断压力性损伤的灵敏度为0.868,特异度为0.184。超声技术评分的AUC为0.898(95%CI 0.852~0.944,P<0.001)。以超声技术评分≥1分为切点时,诊断压力性损伤的灵敏度为0.962,特异度为0.767。Braden量表评分与超声技术联合对严重多发伤患者压力性损伤发生风险的AUC为0.927(95%CI 0.887~0.958,P<0.0001)。以Braden量表评分≤12分和超声技术评分≥1分为切点时,灵敏度为0.975,特异度为0.819。结论对于严重多发伤患者,Braden量表的压力性损伤预测特异度较差,Braden量表联合超声技术评估压力性损伤风险是一种更为优化的手段。

Objective To investigate the value of the ultrasound technique score and the Braden scale in jointly predicting the risk of pressure injuries in patients with severe multiple injuries.Methods According to the inclusion and exclusion criteria,216 patients who were hospitalized in the Affiliated Central Hospital of Chongqing University from December 2022 to December 2023 were enrolled.The Braden scale and body surface ultrasound test results of each patient were collected,and the subject operating characteristic(ROC)curves of the Braden scale,the ultrasound score,and the Braden scale combined with the ultrasound score were counted respectively,and the area under the curve(AUC),sensitivity,specificity,and other predictive indexes were calculated,so as to analyze and compare the clinical value of the prediction of the combined means.Results The incidence of pressure injuries in patients with severe multiple injuries was 24.5%.The AUC of the Braden scale for the risk of pressure injuries in patients with severe multiple injuries was 0.602[95%confidence interval(95%CI)0.507-0.696,P=0.026].The sensitivity for diagnosing pressure injuries was 0.868 and the specificity was 0.184 when using a Braden score of 12 as the cut-off point.The AUC for the ultrasound technique score was 0.898(95%CI 0.852-0.944,P<0.001).The sensitivity for diagnosing pressure injuries was 0.962 and the specificity was 0.767 when using an ultrasound score of≥1 as the cut-off point.The AUC for the combination of the Braden score and the ultrasound technique for the risk of developing pressure injuries in patients with severe multiple injuries was 0.927(95%CI 0.887-0.958,P<0.0001).The sensitivity was 0.975 and the specificity was 0.819 when Braden score≤12 and ultrasound score≥1 were used as cut-off points.Conclusion In patients with severe multiple injuries,the specificity of the Braden scale for pressure injuries prediction is poor,and the Braden score combined with the ultrasound technology is a more optimized means of assessing pressure injuries risk.