A comparative study of Braden and Waterlow scales in predicting the incidence of bed sores in intensive care units

Bed sore is one of the major problems in patients admitted to intensive care units. Two common tools for assessing the risk of bed sore are the Braden and Waterlow scales. There is very little evidence of agreement between the two scales in predicting the incidence of bed sore.

The present study was a prospective cohort study that was performed from July to November 2017 in the ICU of hospitals affiliated to Isfahan University of Medical Sciences. The risk of bed sore was assessed every two days using two scales, Braden and Waterloo, until the patient died or was discharged for a maximum of one month.

The findings of the study showed that the average Braden scale score in patients who developed bedsores was significantly lower than that of patients who did not develop bedsores (P = 0.002), also the average score of Waterloo in patients who developed bedsores was significantly higher than the patients who did not find bedsores (P<0.001). Braden scale sensitivity was 82.6% and specificity was 53.6% and positive predictive value and negative predictive value were 29.7% and 92.9%, respectively. Waterlow scale sensitivity was 73.9% and specificity was 68% and positive predictive value and negative predictive value were 35.4% and 91.7%, respectively.

Considering the area under the curve of the two scales as well as the sum of the two sensitivity and specificity indices, the Waterlow scale is a more suitable tool for predicting bed sores in patients than the Braden scale.