Application of three stress injury assessment scales in elderly patients with hip fracture during perioperative period

doi:10.3877/cma.j.issn.2096-0263.2021.04.006

Abstract

Abstract:

Objective

To explore the application effect of Braden, Waterlow and Munro pressure injury risk assessment scales in perioperative period of senile patients with brittle fracture of hip.

Methods

In this study, convenient sampling method was used to select the elderly patients with hip fracture during the perioperative period from August to December in 2019 and from October to November in 2019 in two Grade-A hospitals, and the risk assessment and nursing of 180 patients before, during and after operation were carried out using three risk assessment scales for pressure injury. SPSS17.0 and Chinese MedCalc19.5.2 statistical software were used for data analysis.

Results

The incidence of perioperative stress injury in senile patients with brittle fracture of hip was 15%. The indexes of Braden, Waterlow and Munro were 0.1285, 0.3878 and 0.1264 respectively before, during and after operation. 0.6471, 0.5490, 0.5599. The area under the ROC curve was 0.565, 0.716 and 0.571, respectively, 0.856, 0.809, 0.835; 0.757, 0.793, 0.820.

Conclusion

The comprehensive predictive ability of Waterlow risk assessment scale is superior to Braden and Munro risk assessment Scale, which is more suitable for the risk screening of pressure injury in the perioperative period of elderly patients with hip fracture, and can be preferred.

Key words: Hip fractures, Perioperative period, Pressure ulcer, Risk assessment

Linping Yan, Yi Cui, Hongyan Zhou, Ying Zhou, Wen Qi Zhou, Yahui Zhang, Xiaomei Dong. Application of three stress injury assessment scales in elderly patients with hip fracture during perioperative period[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(04): 231-237.

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References 32

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量表	评分时段	临界值	敏感性（%）	特异性（%）	+PV（%）	-PV（%）	约登指数
Braden	术前	11	25.93	86.93	25.9	86.9	0.1285
	术中	11	62.96	75.82	31.5	92.1	0.3878
	术后	13	51.85	60.78	18.9	87.7	0.1264
Waterlow	术前	17	100	64.71	33.3	100	0.6471
	术中	29	88.89	66.01	31.6	97.1	0.5490
	术后	22	92.59	63.40	30.9	98.0	0.5599
汉化版Munro	术前	8	85.19	53.59	24.5	95.3	0.3878
	术中	20	85.19	64.71	29.9	96.1	0.4989
	术后	23	88.89	60.13	28.2	96.8	0.4902

量表	评分时段	临界值	敏感性（%）	特异性（%）	+PV（%）	-PV（%）	约登指数
Braden	术前	11	25.93	86.93	25.9	86.9	0.1285
	术中	11	62.96	75.82	31.5	92.1	0.3878
	术后	13	51.85	60.78	18.9	87.7	0.1264
Waterlow	术前	17	100	64.71	33.3	100	0.6471
	术中	29	88.89	66.01	31.6	97.1	0.5490
	术后	22	92.59	63.40	30.9	98.0	0.5599
汉化版Munro	术前	8	85.19	53.59	24.5	95.3	0.3878
	术中	20	85.19	64.71	29.9	96.1	0.4989
	术后	23	88.89	60.13	28.2	96.8	0.4902

量表	评分时段	AUC面积	标准误差	P	95%的置信区间
量表	评分时段	AUC面积	标准误差	P	上限	下限
Braden	术前	0.565	0.0627	0.296	0.490	0.639
	术中	0.716	0.0573	0.000	0.644	0.781
	术后	0.571	0.0575	0.219	0.495	0.644
Waterlow	术前	0.856	0.0297	0.000	0.796	0.904
	术中	0.809	0.0362	0.000	0.744	0.864
	术后	0.835	0.0328	0.000	0.772	0.886
汉化版Munro	术前	0.757	0.0434	0.000	0.688	0.818
	术中	0.793	0.0471	0.000	0.726	0.850
	术后	0.820	0.0459	0.000	0.756	0.873

量表	评分时段	AUC面积	标准误差	P	95%的置信区间
量表	评分时段	AUC面积	标准误差	P	上限	下限
Braden	术前	0.565	0.0627	0.296	0.490	0.639
	术中	0.716	0.0573	0.000	0.644	0.781
	术后	0.571	0.0575	0.219	0.495	0.644
Waterlow	术前	0.856	0.0297	0.000	0.796	0.904
	术中	0.809	0.0362	0.000	0.744	0.864
	术后	0.835	0.0328	0.000	0.772	0.886
汉化版Munro	术前	0.757	0.0434	0.000	0.688	0.818
	术中	0.793	0.0471	0.000	0.726	0.850
	术后	0.820	0.0459	0.000	0.756	0.873

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