The prognostic value of the Braden scale on all-cause death in older patients with heart failure in the intensive care unit: a cohort study.

Background: Heart failure(HF) remains a major global health challenge associated with high mortality rates.The Braden scale score(BSS) is one of the most commonly used clinical tools to assess a patient's risk of pressure injury, and some studies have reported that it may reflect the patient's frailty status. The aim of this study was to investigate whether the BSS can predict the short- and long-term risk of all-cause mortality in elderly patients with heart failure in the intensive care unit (ICU).

Methods and results: Data from the Medical Information Mart for Intensive Care-IV3.0 (MIMIC-IV 3.0)database for HF patients aged 60 years and older within 24 h of admission were used for this analysis. The required data were extracted, and the data collection period spanned from 2009 to 2023.The primary outcomes for HF patients were 30-day and 1-year all-cause mortality. The Cox proportional hazards model and Kaplan - Meier survival curves were used to determine the association between BSS and death, and Hazard Ratios (HR) and 95% confidence intervals (CI) were calculated. Subgroup analysis was used to determine the association between BSS and death in populations with different characteristics. Through screening, we included 13,127 patients with HF in the study. Based on previous literature and sensitivity calculated from current data, participants were divided into two risk groups using a cutoff value of 15.After cox regression analysis to exclude confounding factors, patients in the medium-to-high-risk group (BSS≤15) had a significantly higher 30-day all-cause mortality rate than those in the low-risk group (corrected HR: 1.732, 95% CI: 1.562 ∼ 1.920, p<0.001).Kaplan-Meier survival curves showed poor 30-day, 90-day, and 180-day outcomes in the medium-high risk group.

Conclusions: The Braden scale score is a significant predictor of 30-day all-cause mortality in elderly HF patients admitted to the ICU. All-cause mortality was significantly higher when the BSS was≤15. Also, the occurrence of pressure injuries increases the risk of all-cause mortality in elderly HF patients in the ICU.