Acurácia de escalas de avaliação de risco para úlcera por pressão em pacientes críticos

• Autor(a) principal: Araújo, Thiago Moura de
• Data de Publicação: 2009
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/2048
• topic: Úlcera por Pressão; Prevenção Secundária; Medição de Risco

The pressure ulcer (PU) is a common clinical manifestation in patients of Intensive Care Unit (ICU) and indirect reflection of assistance from health professionals. The emergence of PU in critically ill patients is related to higher expenses, length of stay and clinical complications, therefore, predict which subjects more vulnerable to this problem is fundamental. In the literature there are various scales published for this purpose. However, in Brazil, so far, is not content that they have found that the best scale to measure the risk of developing UP. The objective of this stuy is to verify the accuracy of risk evaluation scales to ulcer by pressure of Norton, Braden and Waterlow in critic patients and to verify the incidence of ulcer by pressure in critic patients. Longitudinal study accomplished in four intensive therapy units in a school-hospital in Fortaleza-Brazil, between March and July 2009. 42 critic patients have been investigated, each subject went through a 10 to 15 days monotoring, in each day of this period the risk evaluation scales to ulcer by pressure of Norton, Braden and Waterlow was applied. During the analysis of data the Qui-Quadrado test was applied to verify the associations among the categoric variables and the T de Student test to compare the continuous variables. Besides this, there was the coeficient calculation of validiy and Spearman. Of the 42 evaluated pacients, 25 developed ulcer by pressure showing an incidence of 59,5%. About the statement we observed (48,9%) with grade I and 24(51,1%) with grade II. The occipital and sacral region were the sites where most injuries occurred (38.3%). Those who developed UP, the presence of two lesions was the predominant 64%. The Norton an Waterlow scales presented the same validation coeficients, both showed sensibility, positive and negative predictive value of 100%. The Braden scale showed sensibility, specialty, positive and negative predictive value of 31,2%, 88,2%, 71,4% and 64,4%, respectively. By the Waterlow method there was a bigger incidence of lesions (23,8%), in relation to the other methods, being the average of lesions, by Waterlow, practically three times bigger than the Norton (p=0,004).By the Braden method, the bigger the age, the bigger the UP (p=0,012).