Risk predictor instruments for pressure injuries in critically ill patients

Abstract

Objective: To identify, among the Waterlow, Cubbin & Jackson and EVARUCI risk prediction instruments for pressure injuries (PI), the most specific and sensitive for patients in Intensive Care Units (ICU)). Methods: This is an observational, analytical and prospective study, carried out in two ICUs in São Paulo, Brazil, from August to November 2019. Participants were 91 adult patients who did not have PI at the time of admission to the ICU and who had been hospitalized in the ICU for more than 24 hours. Data were collected from medical records and through clinical assessment. The association between clinical and personal variables and PI occurrence was performed using Student’s t test and chi-square test, and the instruments’ sensitivity and specificity were assessed using the ROC curve. Results: There was a predominance of males (54.9%), mean age of 66.2 ± 20.8 years and hospitalization for clinical reasons (64.9%). Vasoactive drug use, mechanical ventilation, mechanical restraint, sedation, devices, severity and origin were associated with PI development. The area under the curve for Cubbin & Jackson, EVARUCI and Waterlow were, respectively, 0.91, 0.96 and 0.76, and EVARUCI demonstrated the highest accuracy (90.1%). Conclusion: The Cubbin & Jackson and EVARUCI instruments showed high sensitivity and specificity for PI risk assessment in patients admitted to ICUs, and EVARUCI showed better accuracy.