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Revalidation of a Perioperative Risk Assessment Measure for Skin

机译：恢复皮肤围手术期风险评估措施

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Background Validated perioperative pressure injury (PI) risk assessment measures are few and often cumbersome to complete, leading to missed opportunities to identify and target prevention interventions to those patients at increased risk for developing a postsurgical PI. Objectives Previous validation of a six-item perioperative risk assessment measure for skin (PRAMS) was conducted in our community hospital with positive findings. The purpose of this study was to increase generalizability by revalidating the PRAMS in a larger sample. Methods This was a retrospective chart review of all surgical patients aged >= 18 years positioned in the supine or lateral position in a Midwest quaternary care, multispecialty, 1,500-bed hospital during a 6-month period (n = 1,526). The intent of the study was to revalidate the PRAMS. The main outcome of interest was the development of PI after surgery. Risk indicators of interest included diabetes, age, surgical time, Braden score, previous surgery, and preexisting PI. The diagnostic ability of any of the risk indicators on the development of a postsurgical PI was evaluated using sensitivity, specificity, and predictive values. Results Postsurgical PIs occurred in 121 patients. Comparing current to previous study results, the PRAMS was effective in identifying surgical patients at risk for PI (sensitivity = .98). Those patients with a postsurgical PI had a lower mean Braden score, were more likely to have a preexisting PI, and were more likely to have a previous surgery during the same admission (p < .001 for all risk indicators), comparing favorably to the original study. Patients without risk indicators were unlikely to develop a postsurgical PI (negative predictive value = .98). Discussion Results of this validation study demonstrate that the PRAMS is effective in identifying patients who developed a postsurgical PI using information readily available to the perioperative staff.
机译：背景技术透明围手术期压力损伤（PI）风险评估措施很少，并且往往繁琐地完成，导致错过了识别和针对这些患者的患者的机会，以增加开发后期PI的风险。目的在我们的社区医院进行了积极的发现，在我们的社区医院进行了以前验证了皮肤皮肤（婴儿车）的六项围手术期风险评估措施。本研究的目的是通过在更大的样本中重新验证持久性来提高普遍性。方法这是在6个月期间，在中西部或横向位置定位的所有手术患者= 18岁以下的外科患者（N = 1,526）中的仰卧位或横向位置的回顾性审查。该研究的目的是重新验证婴儿车。兴趣的主要结果是手术后PI的发展。兴趣风险指标包括糖尿病，年龄，手术时间，勃拉明评分，以前的手术和预先存在的pi。使用敏感性，特异性和预测值评估任何风险指标对后期PI的诊断能力。结果后期PIS发生在121名患者中。比较目前对先前的研究结果，婴儿车有效鉴定PI风险的手术患者（敏感性= .98）。那些后勤PI的患者具有较低的平均勃兰登评分，更有可能具有预先存在的PI，并且更容易在同一录取期间（所有风险指标的P <.001）进行先前的手术，有利地比较原学研究。没有风险指标的患者不太可能开发后勤PI（负预测值= .98）。该验证研究的讨论结果表明，婴儿车有效地识别使用围手术人员易于使用的信息开发后勤PI的患者。

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