Comparing the accuracy of the braden and the waterlow scales for pressure ulcer risk assessment in intensive care unit


1 Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

2 Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran

3 Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Department of Nursing, Boroujerd School of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran


Background: Pressure ulcer (PU) is a common problem in intensive care unit (ICU). Risk assessment is the first step to PU prevention. Nonetheless, there is no consensus over the best PU risk assessment scale. Objectives: The objective of the present study was to compare the accuracy of the Braden and the Waterlow scales in predicting the risk of PU in ICU. Methods: This cross-sectional study was conducted in 2019 on 186 patients hospitalized in ICUs of Tohid and Kowsar teaching hospitals, Sanandaj, Iran. The Braden and the Waterlow scales were simultaneously used by two trained nurses for daily PU risk assessment for 15 consecutive days. The predictive validity of the scales was assessed in terms of sensitivity, specificity, and positive and negative predictive values. Results: The mean of participants' age was 55.6 ± 20.3 years. In total, 102 participants (54.8%) developed PU during the study. The sensitivity and the specificity of the Braden scale at the cutoff score of 18 were 97% and 34.5% and the sensitivity and the specificity of the Waterlow scale at the cutoff score of 10 were 95% and 28.5%, respectively. Conclusion: Compared with the Waterlow scale, the Braden scale has a slightly better predictive validity for PU risk assessment.


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