Predictive validity of the Braden scale, Norton scale and Waterlow scale in Slovak Republic

Abstract

Aim: To determine the levels of predictive validity of scales for assessing the risk of pressure ulcers (Braden, Norton and Waterlow scales) in the Slovak clinical setting. Design: A prospective study. Methods: One hundred patients staying in a long-term care department of a hospital from April to August 2014 were investigated using the Braden, Norton and Waterlow scales. The inclusion criteria were age over 18 years and having no pressure ulcers on admission to the department. The predictive validity of the pressure ulcer risk assessment scales was evaluated based on sensitivity, specificity, positive and negative predictive values and the area under the ROC curve. Results: The incidence of pressure ulcers in the study was 14%. The sensitivity, specificity, positive predictive value and negative predictive value were 85.71%, 53.48%, 23.07% and 95.83%, respectively, for the Braden Scale (a cut-off point of 15); 85.71%, 48.83%, 21.42% and 95.45%, respectively, for the Norton Scale (a cut-off of 12); and 85.71%, 30.23%, 16.66% and 92.85%, respectively, for the Waterlow Scale (a cut-off of 13). The areas under the ROC curve were 0.696 (Braden), 0.672 (Norton) and 0.579 (Waterlow). Conclusion: In the present study, the best predictive validity values, with little differences, were observed for the Braden Scale, followed by the Norton Scale and the Waterlow Scale, in that order.

Keywords

• Braden Scale
• Norton Scale
• Waterlow Scale
• pressure ulcer
• risk assessment
• validity