RISK ASSESSMENT OF DECUBITUS ULCERS USING FOUR SCALES AMONG PATIENTS ADMITTED IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS IN A TERTIARY CARE SET UP: A CROSS-SECTIONAL STUDY

Background and objectives: Pressure ulcers are the third most expensive disorder after cancer and cardiovascular diseases. For predicting the risk factors early among patients admitted in intensive care units, all critically ill patient should be screened for presence of all possible risk factors. There is no single specific tool for risk assessment which can predict almost all risk factors. Least studies have been done in Indian scenario to compare and suggest a better predictor of risk assessment for presence of pressure ulcers. The objectives of the present study was to assess & predict the risk for decubitus ulcer using Braden, Norton, Waterlow and Cubbin & Jackson scale as well as to compare better predictor score / tool among these four scales in patients admitted in M.I.C.U. & S.I.C.U. in Indian scenario. Materials and Methodology: A total of one hundred fifty (150) subjects adult males and females admitted in I.C.U within 48 hours were included in the study. Braden scale, Norton scale, Waterlow scale and Cubbin & Jackson scale were administered by two physiotherapy interns. Results: The data was analyzed using student's paired t test, Chi square test and single way ANOVA. Statistically significant differences were noted when the test scores were compared to age (58-77) years (p=0.0308) nutritional status(underweight & obesity) (p=0.0174), mechanical ventilation (p=0.00001), musculoskeletal problems (p=0.0333), type II Diabetes Mellitus (p=0.0003) that have shown to contribute higher risk for development of decubitus ulcers. Cubbin & Jackson scale have shown to be the best predictive value with 99.3% sensitivity and 55.5% specificity compared to other scores. Conclusion: The present cross-sectional study concluded that the Cubbin and Jackson scale is a better predictor of risk of pressure ulcer in Indian scenario. In addition, Nutritional status, age group of 58-77 years, Type II diabetes mellitus and musculoskeletal problems have demonstrated to be risk factors for development of pressure ulcers in ICU admitted patients.