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
目的评价不同压力性损伤风险评估工具对ICU患者压力性损伤风险预测的准确性,为准确筛查ICU压力性损伤风险患者提供依据。方法计算机检索PubMed、Cochrane Library、CINAHL、EMbase、Web of Science、中国知网、维普网、万方数据和中国...目的评价不同压力性损伤风险评估工具对ICU患者压力性损伤风险预测的准确性,为准确筛查ICU压力性损伤风险患者提供依据。方法计算机检索PubMed、Cochrane Library、CINAHL、EMbase、Web of Science、中国知网、维普网、万方数据和中国生物医学文献服务系统中ICU患者压力性损伤风险评估工具相关研究,经文献筛选、质量评价、资料提取后,采用ANOVA模型实现基于贝叶斯方法的诊断实验准确性网状Meta分析。结果共纳入28篇文献,共计11221例患者,涵盖12个压力性损伤风险评估工具。Meta分析结果显示,改良版Cubbin&Jackson量表优势指数最高,灵敏度[0.72,95%CI(0.59,0.82)],特异度[0.75,95%CI(0.63,0.84)],其次为EVARUCI量表,灵敏度[0.75,95%CI(0.54,0.90)],特异度[0.65,95%CI(0.42,0.83)];Braden量表优势指数最低,灵敏度[0.66,95%CI(0.62,0.71)],特异度[0.58,95%CI(0.54,0.61)]。结论改良版Cubbin&Jackson量表、EVARUCI量表具有较好的诊断试验准确性,临床医护人员评估ICU患者压力性损伤风险时可优先选用。展开更多
目的:比较改良版Munro围术期成人压疮风险评估量表与斯卡特触发点对手术患者发生压力性损伤的预测效度及评估的一致性。方法:采用病例对照研究方法,选取2017年至2019年在重庆医科大学附属第二医院进行手术的患者270名,收集一般资料和手...目的:比较改良版Munro围术期成人压疮风险评估量表与斯卡特触发点对手术患者发生压力性损伤的预测效度及评估的一致性。方法:采用病例对照研究方法,选取2017年至2019年在重庆医科大学附属第二医院进行手术的患者270名,收集一般资料和手术资料,将确诊已发生手术获得性压力性损伤的45名患者作为病例组,根据手术科室采用1∶5配对方法,选取同期进行手术但未发生手术获得性压力性损伤的225名患者作为对照组,使用改良版Munro量表与斯卡特触发点分别评分并记录,计算受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC),以及量表的约登指数、灵敏度、特异度、阳性预测值、阴性预测值、κ值。结果:病例组和对照组Munro量表评分分别为(29.870±3.279)分、(26.460±3.381)分,斯卡特触发点评分分别为(2.361±0.900)分、(1.650±0.989)分。Munro量表的AUC=0.764(95%CI=0.692~0.873),最佳诊断界值、灵敏度、特异度、阳性预测值、阴性预测值分别为28.500、0.667、0.720、0.248、0.934;斯卡特触发点AUC=0.691(95%CI=0.610~0.772),最佳诊断界值、灵敏度、特异度、阳性预测值、阴性预测值分别为1.500、0.822、0.502、0.289、0.923。两种评估量表的κ值为0.497,差异有统计学意义(P<0.05)。结论:改良版Munro量表与斯卡特触发点均能有效评估患者发生手术获得性压力性损伤的风险,存在中度一致性。从临床实际工作出发,术前采用改良版斯卡特触发点对手术患者压力性损伤风险进行评估具有可操作性,值得推广。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.
文摘目的评价不同压力性损伤风险评估工具对ICU患者压力性损伤风险预测的准确性,为准确筛查ICU压力性损伤风险患者提供依据。方法计算机检索PubMed、Cochrane Library、CINAHL、EMbase、Web of Science、中国知网、维普网、万方数据和中国生物医学文献服务系统中ICU患者压力性损伤风险评估工具相关研究,经文献筛选、质量评价、资料提取后,采用ANOVA模型实现基于贝叶斯方法的诊断实验准确性网状Meta分析。结果共纳入28篇文献,共计11221例患者,涵盖12个压力性损伤风险评估工具。Meta分析结果显示,改良版Cubbin&Jackson量表优势指数最高,灵敏度[0.72,95%CI(0.59,0.82)],特异度[0.75,95%CI(0.63,0.84)],其次为EVARUCI量表,灵敏度[0.75,95%CI(0.54,0.90)],特异度[0.65,95%CI(0.42,0.83)];Braden量表优势指数最低,灵敏度[0.66,95%CI(0.62,0.71)],特异度[0.58,95%CI(0.54,0.61)]。结论改良版Cubbin&Jackson量表、EVARUCI量表具有较好的诊断试验准确性,临床医护人员评估ICU患者压力性损伤风险时可优先选用。
文摘目的:比较改良版Munro围术期成人压疮风险评估量表与斯卡特触发点对手术患者发生压力性损伤的预测效度及评估的一致性。方法:采用病例对照研究方法,选取2017年至2019年在重庆医科大学附属第二医院进行手术的患者270名,收集一般资料和手术资料,将确诊已发生手术获得性压力性损伤的45名患者作为病例组,根据手术科室采用1∶5配对方法,选取同期进行手术但未发生手术获得性压力性损伤的225名患者作为对照组,使用改良版Munro量表与斯卡特触发点分别评分并记录,计算受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC),以及量表的约登指数、灵敏度、特异度、阳性预测值、阴性预测值、κ值。结果:病例组和对照组Munro量表评分分别为(29.870±3.279)分、(26.460±3.381)分,斯卡特触发点评分分别为(2.361±0.900)分、(1.650±0.989)分。Munro量表的AUC=0.764(95%CI=0.692~0.873),最佳诊断界值、灵敏度、特异度、阳性预测值、阴性预测值分别为28.500、0.667、0.720、0.248、0.934;斯卡特触发点AUC=0.691(95%CI=0.610~0.772),最佳诊断界值、灵敏度、特异度、阳性预测值、阴性预测值分别为1.500、0.822、0.502、0.289、0.923。两种评估量表的κ值为0.497,差异有统计学意义(P<0.05)。结论:改良版Munro量表与斯卡特触发点均能有效评估患者发生手术获得性压力性损伤的风险,存在中度一致性。从临床实际工作出发,术前采用改良版斯卡特触发点对手术患者压力性损伤风险进行评估具有可操作性,值得推广。
