Aims:Paediatric pressure ulcers are a serious problem to healthcare service.Thus,effective and early identification of the risk of developing pressure ulcer is essential.The Braden Q scale is a widely used tool in the...Aims:Paediatric pressure ulcers are a serious problem to healthcare service.Thus,effective and early identification of the risk of developing pressure ulcer is essential.The Braden Q scale is a widely used tool in the risk assessment of paediatric pressure ulcer,but its predictive power is controversial.Hence,we performed a meta-analysis to evaluate the predictive power of the Braden Q scale for pressure ulcer in hospitalised children and offer recommendations for clinical decision.Methods:Studies that evaluated the predictive power of the Braden Q scale were searched through databases in English and Chinese,including Medline,Cochrane Library,Embase,CINAHL,SinoMed,CNKI,Wangfang and VIP.The studies were screened by two independent reviewers.QUADAS-2 was used to assess the risk of bias of eligible studies.Demographic data and predictive value indices were extracted.The pooled sensitivity,specificity and receiver operating characteristics(ROC)were calculated by MetaDiSc 1.4 using random-effects models.Results:Cochran Q=26.13(P=0.0036)indicated the existence of heterogeneity;the I2 for pooled DOR was 61.7%,suggesting significant heterogeneity among the included studies.The pooled sensitivity and specificity were 0.73(95%CI:0.67-0.78)and 0.61(95%CI:0.59-0.63),respectively,yielding a combined DOR of 3.47(95%CI:2-6.01).The area under the ROC curve was 0.7078±0.0421,and the overall diagnostic accuracy(Q*)was 0.6591±0.0337.Sensitivity analysis showed the results were robust.Conclusion:The Braden Q scale has moderate predictive validity with medium sensitivity and low specificity for pressure ulcers in hospitalised children.Further development and modification of this tool for use in paediatric population are warranted.展开更多
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 ...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 bed-ridden 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 pres-sure 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 the 95% 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.展开更多
目的：评价和确定Braden-Q儿童压疮评估量表用于诊断住院患儿压疮高风险的最佳临界值。方法：对2014年1至6月在我院住院且Braden-Q量表≤24分的372例患者进行住院期间压疮发生情况追踪分析,采用灵敏度、特异度、阳性预测值、阴性预测值...目的：评价和确定Braden-Q儿童压疮评估量表用于诊断住院患儿压疮高风险的最佳临界值。方法：对2014年1至6月在我院住院且Braden-Q量表≤24分的372例患者进行住院期间压疮发生情况追踪分析,采用灵敏度、特异度、阳性预测值、阴性预测值、约登指数和受试者工作特征曲线（receiver operating characteristic,ROC）确定和评价Braden-Q量表诊断压疮高度危险的临界值。结果：372例研究对象中有37.73%的患者Braden-Q评分≤16分（最低11分）,72.27%的患者Braden-Q评分17～24分;共发生院内压疮21例,其分值主要集中在13～16分。当Braden-Q量表诊断压疮高危的临界值为16分时,其预测压疮危险的灵敏度为0.826,特异度为0.759,阳性预测值为0.185,阴性预测值为0.985,约登指数（0.585）较其他临界值更大,Braden-Q量表ROC曲线下面积（area under curve,AUC）为0.923。结论：Braden-Q量表16分是诊断儿童压疮高度危险的最佳临界值,能够很好地预测儿童发生压疮的风险,具有较高的诊断价值。展开更多
目的:探讨基于儿童压疮危险评估(Braden-Q)量表行经皮氧分压(TcPO2)监测评估新生儿头枕部压疮发生的价值,为新生儿救护中心(NICU)早期预警压疮提供依据。方法:选择2018年10月-2019年4月笔者所在医院新生儿救护中心(NICU)收治的60例新生...目的:探讨基于儿童压疮危险评估(Braden-Q)量表行经皮氧分压(TcPO2)监测评估新生儿头枕部压疮发生的价值,为新生儿救护中心(NICU)早期预警压疮提供依据。方法:选择2018年10月-2019年4月笔者所在医院新生儿救护中心(NICU)收治的60例新生儿为研究对象,在入院时均应用Braden-Q量表评估压疮危险评分,同时经皮氧分压(TcPO2)监测患儿头枕部皮肤组织的氧合状况。根据在NICU期间是否发生压疮将其分为压疮组(22例)和非压疮组(38例)。比较两组Braden-Q量表评分、TcPO2,采用受试者工作特征(ROC)曲线,评价TcPO2监测对新生儿头枕部压疮的早期预测效果。结果:压疮组Braden-Q量表评分为(16.25±2.22)分,低于非压疮组的(22.88±4.92)分,差异有统计学意义(t=6.751,P=0.013)。压疮组低、中、高危构成比例分别为13.64%、45.45%、40.91%,非压疮组分别为50.00%、42.11%、7.89%,两组低危、高危构成比例比较差异有统计学意义(P<0.05)。压疮组与非压疮组新生儿入住NICU第3、5、7天TcPO2均低于第1天,且呈逐渐下降趋势,差异有统计学意义(P<0.05);压疮组第1、3、5、7天TcPO2低于非压疮组,差异均有统计学意义(P<0.05)。新生儿TcPO2的最佳截断值为87.03 mm Hg,ROC曲线下面积(AUC值)为0.728,敏感性为90.91%,特异性为60.53%,95%CI(0.768,0.927)。结论:基于Braden-Q量表行经皮氧分压监测评估新生儿头枕部压疮发生的价值显著,可更好地为压疮的发生提供预警。展开更多
文摘Aims:Paediatric pressure ulcers are a serious problem to healthcare service.Thus,effective and early identification of the risk of developing pressure ulcer is essential.The Braden Q scale is a widely used tool in the risk assessment of paediatric pressure ulcer,but its predictive power is controversial.Hence,we performed a meta-analysis to evaluate the predictive power of the Braden Q scale for pressure ulcer in hospitalised children and offer recommendations for clinical decision.Methods:Studies that evaluated the predictive power of the Braden Q scale were searched through databases in English and Chinese,including Medline,Cochrane Library,Embase,CINAHL,SinoMed,CNKI,Wangfang and VIP.The studies were screened by two independent reviewers.QUADAS-2 was used to assess the risk of bias of eligible studies.Demographic data and predictive value indices were extracted.The pooled sensitivity,specificity and receiver operating characteristics(ROC)were calculated by MetaDiSc 1.4 using random-effects models.Results:Cochran Q=26.13(P=0.0036)indicated the existence of heterogeneity;the I2 for pooled DOR was 61.7%,suggesting significant heterogeneity among the included studies.The pooled sensitivity and specificity were 0.73(95%CI:0.67-0.78)and 0.61(95%CI:0.59-0.63),respectively,yielding a combined DOR of 3.47(95%CI:2-6.01).The area under the ROC curve was 0.7078±0.0421,and the overall diagnostic accuracy(Q*)was 0.6591±0.0337.Sensitivity analysis showed the results were robust.Conclusion:The Braden Q scale has moderate predictive validity with medium sensitivity and low specificity for pressure ulcers in hospitalised children.Further development and modification of this tool for use in paediatric population are warranted.
文摘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 bed-ridden 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 pres-sure 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 the 95% 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.
文摘目的：评价和确定Braden-Q儿童压疮评估量表用于诊断住院患儿压疮高风险的最佳临界值。方法：对2014年1至6月在我院住院且Braden-Q量表≤24分的372例患者进行住院期间压疮发生情况追踪分析,采用灵敏度、特异度、阳性预测值、阴性预测值、约登指数和受试者工作特征曲线（receiver operating characteristic,ROC）确定和评价Braden-Q量表诊断压疮高度危险的临界值。结果：372例研究对象中有37.73%的患者Braden-Q评分≤16分（最低11分）,72.27%的患者Braden-Q评分17～24分;共发生院内压疮21例,其分值主要集中在13～16分。当Braden-Q量表诊断压疮高危的临界值为16分时,其预测压疮危险的灵敏度为0.826,特异度为0.759,阳性预测值为0.185,阴性预测值为0.985,约登指数（0.585）较其他临界值更大,Braden-Q量表ROC曲线下面积（area under curve,AUC）为0.923。结论：Braden-Q量表16分是诊断儿童压疮高度危险的最佳临界值,能够很好地预测儿童发生压疮的风险,具有较高的诊断价值。
文摘目的:探讨基于儿童压疮危险评估(Braden-Q)量表行经皮氧分压(TcPO2)监测评估新生儿头枕部压疮发生的价值,为新生儿救护中心(NICU)早期预警压疮提供依据。方法:选择2018年10月-2019年4月笔者所在医院新生儿救护中心(NICU)收治的60例新生儿为研究对象,在入院时均应用Braden-Q量表评估压疮危险评分,同时经皮氧分压(TcPO2)监测患儿头枕部皮肤组织的氧合状况。根据在NICU期间是否发生压疮将其分为压疮组(22例)和非压疮组(38例)。比较两组Braden-Q量表评分、TcPO2,采用受试者工作特征(ROC)曲线,评价TcPO2监测对新生儿头枕部压疮的早期预测效果。结果:压疮组Braden-Q量表评分为(16.25±2.22)分,低于非压疮组的(22.88±4.92)分,差异有统计学意义(t=6.751,P=0.013)。压疮组低、中、高危构成比例分别为13.64%、45.45%、40.91%,非压疮组分别为50.00%、42.11%、7.89%,两组低危、高危构成比例比较差异有统计学意义(P<0.05)。压疮组与非压疮组新生儿入住NICU第3、5、7天TcPO2均低于第1天,且呈逐渐下降趋势,差异有统计学意义(P<0.05);压疮组第1、3、5、7天TcPO2低于非压疮组,差异均有统计学意义(P<0.05)。新生儿TcPO2的最佳截断值为87.03 mm Hg,ROC曲线下面积(AUC值)为0.728,敏感性为90.91%,特异性为60.53%,95%CI(0.768,0.927)。结论:基于Braden-Q量表行经皮氧分压监测评估新生儿头枕部压疮发生的价值显著,可更好地为压疮的发生提供预警。
