Pressure Injury Risk Assessment in Pediatric Intensive Care: A Prospective Validation Study of the Glamorgan Scale and Predictive Comparison with the Braden Q Scale.

OBJECTIVE: To validate the Glamorgan Scale and compare its predictive ability in assessing pressure injury risk among patients in a pediatric ICU (PICU) with that of the Braden Q Scale. METHODS: A prospective cohort study was performed to validate the Glamorgan Scale and compare its predictive ability with the Braden Q Scale in a PICU population. A total of 83 patients admitted in the PICU between February and July 2020 met the inclusion criteria and were included in the study, leading to 639 measurements. The authors tested the psychometric properties of the Glamorgan Scale to validate whether the characteristics of the original version were preserved. To this end, reliability (internal consistency) and concurrent and predictive validity (sensitivity and specificity) were assessed. For the predictive comparison, the authors performed the same tests with the Braden Q Scale. RESULTS: The predictive validity, as assessed by the receiver operator characteristic curve and calculation of the area under the curve, showed satisfactory performance for the Glamorgan Scale (0.77; CI, 0.72-0.82); the Braden Q Scale values were similar (0.78; CI 0.73-0.84). The Spearman correlation coefficient showed a strong correlation between the total scores of the Glamorgan Scale (ρ = -0.76; P < .01), corroborating its validation. CONCLUSIONS: The Glamorgan Scale was validated and showed good accuracy and consistency for pressure injury risk assessment in critically ill pediatric patients in Brazil. Its accuracy was similar to that of the Braden Q Scale.

Intensive Care Pressure Injuries: A Cohort Study Using the CALCULATE and Braden Scales.

OBJECTIVE: Identify both the risk of developing pressure injuries (PIs) by applying the CALCULATE (CriticAL Care pressure ULcer Assessment Tool made Easy) and Braden Scales and the incidence of PIs in adult patients in intensive care. METHODS: This prospective cohort study was conducted from March 2016 to February 2017 in an adult ICU. The Braden and CALCULATE scales were applied every 48 hours until medical discharge, death, or PI development. RESULTS: The sample included 100 patients. The investigators obtained 818 evaluations (409 Braden and 409 CALCULATE) with an average of 4.1 observations per patient. According to the CALCULATE scale, 49 participants (49%) were classified as very high risk, compared with 40 participants (40%; P = .204) according to the Braden Scale. Thirty-five patients developed 37 PIs, with a total incidence of 35%. The mean age of patients who developed PIs was 60.3 (SD, 13.7) years, and they averaged 9.2 (SD, 6.8) days of hospitalization, with diagnoses related to cardiorespiratory and neurologic diseases and associated comorbidities of hypertension, diabetes mellitus, and smoking. The most affected site was the sacral region; 64.9% of the injuries were classified as stage 1. CONCLUSIONS: Patients in intensive care were high risk according to both PI scales, and many developed PIs. It is evident that even when preventive measures are used, they are insufficient without the implementation of preventive protocols.