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目的:评价和确定Braden-Q儿童压疮评估量表用于诊断住院患儿压疮高风险的最佳临界值。方法:对2014年1至6月在我院住院且Braden-Q量表≤24分的372例患者进行住院期间压疮发生情况追踪分析,采用灵敏度、特异度、阳性预测值、阴性预测值、约登指数和受试者工作特征曲线(receiver operating characteristic,ROC)确定和评价Braden-Q量表诊断压疮高度危险的临界值。结果:372例研究对象中有37.73%的患者Braden-Q评分≤16分(最低11分),72.27%的患者Braden-Q评分17~24分;共发生院内压疮21例,其分值主要集中在13~16分。当Braden-Q量表诊断压疮高危的临界值为16分时,其预测压疮危险的灵敏度为0.826,特异度为0.759,阳性预测值为0.185,阴性预测值为0.985,约登指数(0.585)较其他临界值更大,Braden-Q量表ROC曲线下面积(area under curve,AUC)为0.923。结论:Braden-Q量表16分是诊断儿童压疮高度危险的最佳临界值,能够很好地预测儿童发生压疮的风险,具有较高的诊断价值。
OBJECTIVE: To evaluate and determine the optimal cut-off value for Braden-Q Child Pressure Ulcers Evaluation Scale for the diagnosis of high risk of pressure ulcers in hospitalized children. Methods: A total of 372 patients admitted to our hospital from January to June 2014 with a Braden-Q ≤24 were followed up for the duration of hospitalized pressure ulcers. Sensitivity, specificity, positive predictive value, negative predictive value, Youden index and receiver operating characteristic (ROC) were used to determine and evaluate the critical value of the Braden-Q scale for the high risk of pressure ulcers. Results: 37.3% of 372 patients had Braden-Q score ≤16 (lowest 11), 72.27% of patients had Braden-Q score of 17-24, and there were 21 cases of nocturnal pressure ulcers Concentrated in 13 to 16 minutes. The sensitivity of the Braden-Q scale to predicting pressure ulcer risk was 0.826, the specificity was 0.759, the positive predictive value was 0.185, the negative predictive value was 0.985, and the Youden index (0.585 ) Was greater than other critical values. The area under curve (AUC) of the Braden-Q scale was 0.923. Conclusion: The Braden-Q scale 16 points is the best critical value for diagnosing children with high pressure ulcer. It can predict the risk of pressure ulcer in children well and has a high diagnostic value.