소아 환자에서 욕창 위험도 사정 도구의 예측타당도 비 교 : Braden, Braden Q 및 Braden QD 도구
Comparison of the Predictive Validity of the Pressure Injury Risk Assessment in Pediatric Patients: Braden, Braden Q and Braden QD Scale
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목적: 소아 환자를 대상으로 욕창 위험도 사정 도구인 Braden, Braden Q 및 Braden QD 도구의 욕창 발생 예측타당도를 비교하기 위함이다. 방법: 어린이병원에 입원한 19세 미만의 환자를 대상으로 한 전향적 관찰 연구로 욕창 발생 관련 특성 및 Braden, Braden Q, Braden QD도구의 곡선하면적(AUC)을 확인하고 예측타당도를 비교하였다. 결과: 대상자는 총 689명이었다. 욕창이 발생한 대상자는 13명(1.9%)이었고 욕창 발생 건수는 17건이었다. 욕창 발생 관련 요인으로는 부동 9건(52.9%), 의료기기 관련 8건(47.1%)이었다. 각 도구의 AUC는 Braden 도구 .91 (95% CI .89~.94), Braden Q 도구 .92 (95% CI .90~.95), Braden QD 도구 .94 (95% CI .92~.96)이었다. 경계점수는 Braden 도구는 16점(민감도=88.8%, 특이도 86.4%), Braden Q 도구는 17점(민감도=63.6%, 특이도=94.9%), Braden QD 도구는 12점(민감도=94.4%, 특이도 88.7%)이었다. 결론: Braden QD도구는 소아환자에서 가장 높은 욕창 예측타당도를 보였고 이는 소아 욕창 예방을 위한 유용한 도구로 사용될 것으로 기대된다.
Abstract
Purpose: The purpose of this study is to compare the predictive validity of pressure injury risk assessment,Braden, Braden Q and Braden QD for pediatric patients. Methods: Prospective observational study includedpatients under the age of 19 who were hospitalized to general wards, intensive care units of a children’s hospital. Characteristics related to pressure injury were collected, and predicted validity was compared by calculating theareas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. Results: A total of 689 patientswere included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injurieswas 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%)medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95)for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 forBraden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and12 for Braden QD (sensitivity=94.4%, specificity=88.7%). Conclusion: The Braden QD scale demonstrated thehighest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool inpreventing pediatrics pressure injuries.
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