两种量表对肿瘤患者压力性损伤预测效果的比较研究

目的探讨应用两种压力性损伤危险评估量表对肿瘤患者压力性损伤发生的预测效果。方法对入院符合纳入标准的261名患者建立资料登记表,并在入院2 h内对其进行首次评估。由2名经过培训的护士独立应用两种量表对不同危险的患者进行压力性损伤危险评估,每天观察受试者皮肤情况,有无压力性损伤发生及其分期,直到患者压力性损伤观察期满3周或出院、死亡。结果OH量表的最佳诊断界值为1.25,灵敏度、特异度、阳性预测值、阴性预测值分别为84%、62.7%、19.3%、97.4%;Braden评估量表的最佳诊断界值为15.5,灵敏度、特异度、阳性预测值、阴性预测值分别为72%、80.5%、28.1%、96.4%;OH量表和Braden量表的Youden指数分别是0.467和0.525;OH评估量表在ROC曲线下的面积为0.766,低于Braden评估量表0.819。结论OH量表在肿瘤住院患者压力性损伤高危风险预测中并不优于Braden量表,但OH量表与Braden量表的Youden指数均较高且相差不大,提示两者均可以用于恶性肿瘤晚期患者的压力性损伤危险预测,从而有效指引护理人员进行压力性损伤预防措施的选择。

A comparative study of two scales to prediction the stress injury in tumor patients

Objective to explore the prediction of two stress injury risk assessment scales on the occurrence of stress injury in tumor patients.Methods A data registration form was established for the patients who met the inclusion criteria and evaluated for the first time within 2 hours after admission.Two trained nurses independently used two scales to assess the risk of stress injury in patients,and observed the skin condition per-day,stress injury and its stages,until the end of the observation period of stress injury for three weeks or discharge and death.Results The best diagnostic threshold of OH scale was 1.25,the sensitivity,specificity,positive predictive value and negative predictive value were 84%,62.7%,19.3%and 97.4%respectively;meanwhile,the corresponding index of Braden scale were 15.5,72%,80.5%,28.1%and 96.4%respectively.The Youden index of 0 H and Braden scale were 0.467 and 0.525 respectively.The area of the OH scale under ROC curve was 0.766 lower than that of Braden scale 0.819.Conclusion OH scale is not better than Braden scale in predicting the high risk of stress injury in tumor patients,but the Youden index of OH and Braden scale is higher and the difference is not significant.Both scales can be used to predict the risk of stress injury in patients with advanced cancer,and effectively guide nurses to choose the preventive measures for stress injury.