The clinical relevance of the waterlow pressure sore risk scale in the ICU

Objective: To evaluate whether the Waterlow pressure sore risk (PSR) scale has prognostic significance for intensive care patients. Design: A prospective study. Setting: The surgical intensive care unit (ICU) of the University Hospital Rotterdam. Patients: Data were evaluated from 594 patients who had been admitted to the ICU during the year 1994. Methods and results: Each patient was assessed daily with respect to their Waterlow PSR score and the development of pressure sores in the sacral region. Actuarial statistical methods were used to analyse the predictive value of the risk score. When a patient had a Waterlow PSR score > 25 on admission, the risk of developing a pressure sore was significantly increased compared to patients with a PSR score < 25. After admission, the daily Waterlow PSR scores obtained were significantly associated with the risk of developing a pressure sore. For each additional point this risk increased by 23 % (95 % confidence interval 17 to 28 %). Conclusions: The Waterlow PSR scale provides the medical and nursing staff at an early stage with reliable information about the risk patients have in developing a pressure sore. Received: 8 August 1997 Accepted: 24 April 1998