Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients
To determine whether a low Braden skin score (BSS), reflecting increased risk for skin pressure injury, would predict lower survival in cardiac intensive care unit (CICU) patients after adjustment for illness severity and comorbidities. This retrospective cohort study included consecutive unique adu...
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| Veröffentlicht in: | Mayo Clinic proceedings 2019-10, Vol.94 (10), p.1994-2003 |
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| creator | Jentzer, Jacob C. Anavekar, Nandan S. Brenes-Salazar, Jorge A. Wiley, Brandon Murphree, Dennis H. Bennett, Courtney Murphy, Joseph G. Keegan, Mark T. Barsness, Gregory W. |
| description | To determine whether a low Braden skin score (BSS), reflecting increased risk for skin pressure injury, would predict lower survival in cardiac intensive care unit (CICU) patients after adjustment for illness severity and comorbidities.
This retrospective cohort study included consecutive unique adult patients admitted to a single tertiary care referral hospital CICU from January 1, 2007, through December 31, 2015, who had a BSS documented on CICU admission. The primary outcome was all-cause hospital mortality, using elastic net penalized logistic regression to determine predictors of hospital mortality. The secondary outcome was all-cause post-discharge mortality, using Cox proportional hazards models to determine predictors of post-discharge mortality.
The study included 9552 patients with a mean age of 67.4±15.2 years (3589 [37.6%] were females) and a hospital mortality rate of 8.3%. Admission BSS was inversely associated with hospital mortality (unadjusted odds ratio, 0.70; 95% CI, 0.68-0.72; P |
| doi_str_mv | 10.1016/j.mayocp.2019.04.038 |
| format | Article |
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This retrospective cohort study included consecutive unique adult patients admitted to a single tertiary care referral hospital CICU from January 1, 2007, through December 31, 2015, who had a BSS documented on CICU admission. The primary outcome was all-cause hospital mortality, using elastic net penalized logistic regression to determine predictors of hospital mortality. The secondary outcome was all-cause post-discharge mortality, using Cox proportional hazards models to determine predictors of post-discharge mortality.
The study included 9552 patients with a mean age of 67.4±15.2 years (3589 [37.6%] were females) and a hospital mortality rate of 8.3%. Admission BSS was inversely associated with hospital mortality (unadjusted odds ratio, 0.70; 95% CI, 0.68-0.72; P<.001; area under the receiver operator curve, 0.80; 95% CI, 0.78-0.82), with increased short-term mortality as a function of decreasing admission BSS. After adjustment for illness severity and comorbidities using multivariable analysis, admission BSS remained inversely associated with hospital mortality (adjusted odds ratio, 0.88; 95% CI, 0.85-0.92; P<.001). Among hospital survivors, admission BSS was inversely associated with post-discharge mortality after adjustment for illness severity and comorbidities (adjusted hazard ratio, 0.89; 95% CI, 0.88-0. 90; P<.001).
The admission BSS, a simple inexpensive bedside nursing assessment potentially reflecting frailty and overall illness acuity, was independently associated with hospital and post-discharge mortality when added to established multiparametric illness severity scores among contemporary CICU patients.</description><identifier>ISSN: 0025-6196</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.1016/j.mayocp.2019.04.038</identifier><identifier>PMID: 31585582</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Age ; Aged ; Aged, 80 and over ; Algorithms ; Automation ; Cardiac patients ; Cause of Death ; Cohort Studies ; Comorbidity ; Coronary Care Units ; Delirium ; Electronic health records ; Female ; Frailty ; Frailty - complications ; Frailty - diagnosis ; Frailty - mortality ; Geriatric Assessment - methods ; Hospital Mortality ; Hospital patients ; Hospitalization ; Hospitals ; Humans ; Illnesses ; Intensive care ; Laboratories ; Male ; Medical records ; Medical research ; Middle Aged ; Mortality ; Nursing ; Patient Admission ; Patient outcomes ; Patients ; Physiology ; Predictive Value of Tests ; Pressure Ulcer - complications ; Pressure Ulcer - diagnosis ; Pressure ulcers ; Prognosis ; Retrospective Studies ; Sepsis ; Short term ; Skin ; Studies ; Validity</subject><ispartof>Mayo Clinic proceedings, 2019-10, Vol.94 (10), p.1994-2003</ispartof><rights>2019 Mayo Foundation for Medical Education and Research</rights><rights>Copyright © 2019 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.</rights><rights>COPYRIGHT 2019 Frontline Medical Communications Inc.</rights><rights>Copyright Mayo Foundation for Medical Education and Research Oct 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c460t-66a0fa1c285503736156382dfbc9b6c8c71430bcec0d6694282fb2b9627ff7bc3</citedby><cites>FETCH-LOGICAL-c460t-66a0fa1c285503736156382dfbc9b6c8c71430bcec0d6694282fb2b9627ff7bc3</cites><orcidid>0000-0001-7186-1009 ; 0000-0002-6366-2859 ; 0000-0002-7800-455X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2305483961?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31585582$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jentzer, Jacob C.</creatorcontrib><creatorcontrib>Anavekar, Nandan S.</creatorcontrib><creatorcontrib>Brenes-Salazar, Jorge A.</creatorcontrib><creatorcontrib>Wiley, Brandon</creatorcontrib><creatorcontrib>Murphree, Dennis H.</creatorcontrib><creatorcontrib>Bennett, Courtney</creatorcontrib><creatorcontrib>Murphy, Joseph G.</creatorcontrib><creatorcontrib>Keegan, Mark T.</creatorcontrib><creatorcontrib>Barsness, Gregory W.</creatorcontrib><title>Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>To determine whether a low Braden skin score (BSS), reflecting increased risk for skin pressure injury, would predict lower survival in cardiac intensive care unit (CICU) patients after adjustment for illness severity and comorbidities.
This retrospective cohort study included consecutive unique adult patients admitted to a single tertiary care referral hospital CICU from January 1, 2007, through December 31, 2015, who had a BSS documented on CICU admission. The primary outcome was all-cause hospital mortality, using elastic net penalized logistic regression to determine predictors of hospital mortality. The secondary outcome was all-cause post-discharge mortality, using Cox proportional hazards models to determine predictors of post-discharge mortality.
The study included 9552 patients with a mean age of 67.4±15.2 years (3589 [37.6%] were females) and a hospital mortality rate of 8.3%. Admission BSS was inversely associated with hospital mortality (unadjusted odds ratio, 0.70; 95% CI, 0.68-0.72; P<.001; area under the receiver operator curve, 0.80; 95% CI, 0.78-0.82), with increased short-term mortality as a function of decreasing admission BSS. After adjustment for illness severity and comorbidities using multivariable analysis, admission BSS remained inversely associated with hospital mortality (adjusted odds ratio, 0.88; 95% CI, 0.85-0.92; P<.001). Among hospital survivors, admission BSS was inversely associated with post-discharge mortality after adjustment for illness severity and comorbidities (adjusted hazard ratio, 0.89; 95% CI, 0.88-0. 90; P<.001).
The admission BSS, a simple inexpensive bedside nursing assessment potentially reflecting frailty and overall illness acuity, was independently associated with hospital and post-discharge mortality when added to established multiparametric illness severity scores among contemporary CICU patients.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Algorithms</subject><subject>Automation</subject><subject>Cardiac patients</subject><subject>Cause of Death</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Coronary Care Units</subject><subject>Delirium</subject><subject>Electronic health records</subject><subject>Female</subject><subject>Frailty</subject><subject>Frailty - complications</subject><subject>Frailty - diagnosis</subject><subject>Frailty - mortality</subject><subject>Geriatric Assessment - methods</subject><subject>Hospital Mortality</subject><subject>Hospital patients</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Intensive care</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nursing</subject><subject>Patient Admission</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Physiology</subject><subject>Predictive Value of Tests</subject><subject>Pressure Ulcer - complications</subject><subject>Pressure Ulcer - diagnosis</subject><subject>Pressure ulcers</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Short term</subject><subject>Skin</subject><subject>Studies</subject><subject>Validity</subject><issn>0025-6196</issn><issn>1942-5546</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kVGL1DAUhYMo7rj6D0QKgvjSmqRp2r4I4-CuCysuqM8hTW7cjG0zJunC_Hvv0FXUBwncwOU7ybn3EPKc0YpRJt_sq0kfgzlUnLK-oqKidfeAbFgveNk0Qj4kG0p5U0rWyzPyJKU9pbTte_GYnNWs6Zqm4xuitnbyKfkwF--itjAXn797LCZEKK5mCwfAMufxWNxEsN7kVHwMMevR52OB5E5H67VBNsOc_B2cOlDc6OxRlp6SR06PCZ7d3-fk68X7L7sP5fWny6vd9ro0QtJcSqmp08xwtEXrtpaskXXHrRtMP0jTmZaJmg4GDLVS4ogddwMfeslb59rB1Ofk9fruIYYfC6SscCwD46hnCEtSvKZM4BNNi-jLf9B9WOKM7k5UI7q6lwypaqW-6RGUn13IURs8FiZvwgzOY38rqejQBZcoePWH4Bb0mG9TGJeMu01_g2IFTQwpRXDqEP2k41Exqk7Rqr1ao1WnaBUVCqNF2Yt728swgf0t-pUlAm9XAHDPdx6iSgYzMJhaBJOVDf7_P_wEfIu02g</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Jentzer, Jacob C.</creator><creator>Anavekar, Nandan S.</creator><creator>Brenes-Salazar, Jorge A.</creator><creator>Wiley, Brandon</creator><creator>Murphree, Dennis H.</creator><creator>Bennett, Courtney</creator><creator>Murphy, Joseph G.</creator><creator>Keegan, Mark T.</creator><creator>Barsness, Gregory W.</creator><general>Elsevier Inc</general><general>Frontline Medical Communications Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4U-</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7186-1009</orcidid><orcidid>https://orcid.org/0000-0002-6366-2859</orcidid><orcidid>https://orcid.org/0000-0002-7800-455X</orcidid></search><sort><creationdate>201910</creationdate><title>Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients</title><author>Jentzer, Jacob C. ; Anavekar, Nandan S. ; Brenes-Salazar, Jorge A. ; Wiley, Brandon ; Murphree, Dennis H. ; Bennett, Courtney ; Murphy, Joseph G. ; Keegan, Mark T. ; Barsness, Gregory W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c460t-66a0fa1c285503736156382dfbc9b6c8c71430bcec0d6694282fb2b9627ff7bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Algorithms</topic><topic>Automation</topic><topic>Cardiac patients</topic><topic>Cause of Death</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Coronary Care Units</topic><topic>Delirium</topic><topic>Electronic health records</topic><topic>Female</topic><topic>Frailty</topic><topic>Frailty - complications</topic><topic>Frailty - diagnosis</topic><topic>Frailty - mortality</topic><topic>Geriatric Assessment - methods</topic><topic>Hospital Mortality</topic><topic>Hospital patients</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Intensive care</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nursing</topic><topic>Patient Admission</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Physiology</topic><topic>Predictive Value of Tests</topic><topic>Pressure Ulcer - complications</topic><topic>Pressure Ulcer - diagnosis</topic><topic>Pressure ulcers</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Short term</topic><topic>Skin</topic><topic>Studies</topic><topic>Validity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jentzer, Jacob C.</creatorcontrib><creatorcontrib>Anavekar, Nandan S.</creatorcontrib><creatorcontrib>Brenes-Salazar, Jorge A.</creatorcontrib><creatorcontrib>Wiley, Brandon</creatorcontrib><creatorcontrib>Murphree, Dennis H.</creatorcontrib><creatorcontrib>Bennett, Courtney</creatorcontrib><creatorcontrib>Murphy, Joseph G.</creatorcontrib><creatorcontrib>Keegan, Mark T.</creatorcontrib><creatorcontrib>Barsness, Gregory W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Mayo Clinic proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jentzer, Jacob C.</au><au>Anavekar, Nandan S.</au><au>Brenes-Salazar, Jorge A.</au><au>Wiley, Brandon</au><au>Murphree, Dennis H.</au><au>Bennett, Courtney</au><au>Murphy, Joseph G.</au><au>Keegan, Mark T.</au><au>Barsness, Gregory W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients</atitle><jtitle>Mayo Clinic proceedings</jtitle><addtitle>Mayo Clin Proc</addtitle><date>2019-10</date><risdate>2019</risdate><volume>94</volume><issue>10</issue><spage>1994</spage><epage>2003</epage><pages>1994-2003</pages><issn>0025-6196</issn><eissn>1942-5546</eissn><abstract>To determine whether a low Braden skin score (BSS), reflecting increased risk for skin pressure injury, would predict lower survival in cardiac intensive care unit (CICU) patients after adjustment for illness severity and comorbidities.
This retrospective cohort study included consecutive unique adult patients admitted to a single tertiary care referral hospital CICU from January 1, 2007, through December 31, 2015, who had a BSS documented on CICU admission. The primary outcome was all-cause hospital mortality, using elastic net penalized logistic regression to determine predictors of hospital mortality. The secondary outcome was all-cause post-discharge mortality, using Cox proportional hazards models to determine predictors of post-discharge mortality.
The study included 9552 patients with a mean age of 67.4±15.2 years (3589 [37.6%] were females) and a hospital mortality rate of 8.3%. Admission BSS was inversely associated with hospital mortality (unadjusted odds ratio, 0.70; 95% CI, 0.68-0.72; P<.001; area under the receiver operator curve, 0.80; 95% CI, 0.78-0.82), with increased short-term mortality as a function of decreasing admission BSS. After adjustment for illness severity and comorbidities using multivariable analysis, admission BSS remained inversely associated with hospital mortality (adjusted odds ratio, 0.88; 95% CI, 0.85-0.92; P<.001). Among hospital survivors, admission BSS was inversely associated with post-discharge mortality after adjustment for illness severity and comorbidities (adjusted hazard ratio, 0.89; 95% CI, 0.88-0. 90; P<.001).
The admission BSS, a simple inexpensive bedside nursing assessment potentially reflecting frailty and overall illness acuity, was independently associated with hospital and post-discharge mortality when added to established multiparametric illness severity scores among contemporary CICU patients.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>31585582</pmid><doi>10.1016/j.mayocp.2019.04.038</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-7186-1009</orcidid><orcidid>https://orcid.org/0000-0002-6366-2859</orcidid><orcidid>https://orcid.org/0000-0002-7800-455X</orcidid></addata></record> |
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| subjects | Age Aged Aged, 80 and over Algorithms Automation Cardiac patients Cause of Death Cohort Studies Comorbidity Coronary Care Units Delirium Electronic health records Female Frailty Frailty - complications Frailty - diagnosis Frailty - mortality Geriatric Assessment - methods Hospital Mortality Hospital patients Hospitalization Hospitals Humans Illnesses Intensive care Laboratories Male Medical records Medical research Middle Aged Mortality Nursing Patient Admission Patient outcomes Patients Physiology Predictive Value of Tests Pressure Ulcer - complications Pressure Ulcer - diagnosis Pressure ulcers Prognosis Retrospective Studies Sepsis Short term Skin Studies Validity |
| title | Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients |
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