Inception and validation of a pressure ulcer risk scale in oncology

Abstract

To create and validate a specific tool to evaluate the pressure ulcer risk in cancer patients. The Pressure Ulcer Scale in Oncology (PUSO) was developed and subsequently validated against the Norton and Braden scales in order to efficiently and reliably evaluate the pressure ulcer risk in adult cancer patients, with various sites and stages of the illness (both curative and palliative phases). Two series of prevalence surveys (three surveys over two days, at two-month intervals) were conducted in one and then two French Cancer Centres in 2002 and 2009, respectively. The surveys investigated a total of 933 patients. Multivariate logistic regression analysis identified three key items as being predictive of the development of pressure ulcers in cancer patients (mobility, incontinence and moisture/shearing), all with similar odds ratio weighting. A score was defined using this logistic model, the PUSO score (0-3)=bedridden/chair-ridden + incontinence + moisture/shearing. The extreme simplicity of this scale may appear disconcerting, but the PUSO is a simple, reliable and validated tool, which allows standardised evaluation of each patient's risk and, thereby, rapid introduction of appropriate measures.