Using Braden and Waterlow Scales to Predict Pressure Ulcer: A Comparative Study

Introduction: This study aims at determining and comparing Braden and Waterlow predictive tools as well as determining the cut off point of these scales.Methods: This was a cross-sectional study which was carried out on 1864 patients admitted to Imam Hossein Hospital in Shahroud. The data collection instruments included Braden and Waterlow risk–assessment scales and a skin assessment tool. The data were collected through interviews and observation and were analyzed through t-test and ROC curve.Results: Out of 1864 participants in the study, 72 patients developed pressure ulcer. The mean scores obtained through the pressure ulcer assessment in patients with pressure ulcers, on the basis of Braden scale was 13.8 ± 3.6 and in patients without the pressure ulcers was 20.2 ± 3.5. The mean scores based on Waterlow scale in patients with pressure ulcers was 15.6±5.2 and in patients without pressure ulcers it was 10 ± 4.1. The results of t-tests showed significant differences between the mean scores of the two groups based on the two scales (P<0.001). The Braden scale had a sensitivity of 92% and specificity 74% at the cut off point of 18.5 and the Waterlow scale had a sensitivity of 69% and specificity 78% at the cut off point of 12.5.Conclusion: The Braden scale had higher sensitivity and specificity compared to Waterlow scale; therefore, it is one of the appropriate instruments for prediction of patients at risk of developing pressure ulcers.