Comparison of Braden Score vs APACHE to Predict Occurrence of Bed Sores in a Tertiary Care ICU.

Abstract

Introduction: Pressure sores, or bedsores, pose a challenge in intensive care unit (ICU) care due to patients' immobility and compromised circulation. This study explores the effectiveness of the Braden Scale and acute physiology and chronic health evaluation II (APACHE II) in predicting pressure sore occurrences.

Materials and methods: Conducted over a year in an Indian ICU, this observational study assessed the predictive capability of both scores. Participants (≥18 years) underwent Braden and APACHE II assessments upon admission, with daily monitoring for pressure sore development. Statistical analysis compared scores and ulcer occurrences.

Results: Older patients, particularly males, showed a higher tendency for ICU admission. 20.3% had pressure ulcers, significantly correlating with lower Braden and higher APACHE II scores. Acute physiology and chronic health evaluation II showed superior efficiency in predicting ulcers.

Discussion: While Braden scores' variability was less in ICU patients, APACHE II scores reflected acute illness severity, strongly correlating with ulcer incidence. The study advocates for a combined utilization of both scores for tailored interventions.

Conclusion: Acute physiology and chronic health evaluation II demonstrated better efficiency in predicting pressure ulcers, while the Braden score remains valuable for focused assessments. The study highlights the importance of considering age, gender, acute health status, and localized risk factors in ICU pressure ulcer assessment.

Future directions: Further research might explore integrated scoring systems or protocols combining the strengths of both scores for more precise risk assessment in ICU settings.

How to cite this article: Maqbool K, Chauhan M, Dewan S. Comparison of Braden Score vs APACHE to Predict Occurrence of Bed Sores in a Tertiary Care ICU. Indian J Crit Care Med 2025;29(2):164-169.