Predicting the Incidence of Bedsores in Intensive Care Units: Braden Scale versus Waterlow Scale

Abstract

Background and Objectives Bedsores are one of the major problems observed in patients admitted to intensive care units. Two common tools for assessing the risk of bedsores are Braden and Waterlow scales. Evidence for the agreement between these two scales in predicting the incidence of bedsores is scarce. Subjects and Methods This was a prospective cohort study conducted from July to November 2017 in the ICUs of hospitals affiliated to Isfahan University of Medical Sciences. The risk of bedsores was assessed every two days using two scales, namely Braden and Waterlow, for a maximum of one month or until the patient died or was discharged. Results The findings of the study showed that the mean score of Braden scale in patients who developed bedsores was significantly lower than that of patients who did not develop bedsores (P = 0.002). Also, the mean score of Waterlow scale in patients who developed bedsores was significantly higher than that in patients who did not have bedsores (P <0.001). The sensitivity and specificity of the Braden scale were 82.6% and 53.6%, respectively, and its positive and negative predictive values were 29.7% and 92.9%, respectively. Waterlow scale had a sensitivity of 73.9% and a specificity of 68%, and its positive and negative predictive values were 35.4% and 91.7%, respectively. Conclusion Considering the area under the curve of the two scales and the sum of the two sensitivity and specificity indices, the Waterlow scale is a more suitable tool, compared with the Braden scale, for predicting bedsores in patients.