Validation of EMINA and EVARUCI scales for assessing the risk of developing pressure ulcers in critical patients

Objective: To contribute to the validation of the EMINA and EVAUCI scales for assessing the risk of pressure ulcers in the critical patient and compare their predictive capacity in this same context. Method: Prospective study from December 2012 until June 2013. Setting: Polyvalent intensive care unit of 14 beds in a reference hospital for two sanitary areas. Patients: patients of 18 years of age or older and without pressure ulcers were included. They were followed until development of a pressure ulcer of grade I or greater, medical discharge, death or 30 days. Main variables: presence of ulcers, daily score of the risk of developing pressure ulcers through EMINA and EVARUCI evaluation. The validity of both scales was calculated using sensitivity, specificity, and positive and negative predictive value. The level of significance was P<0.05. Results: A total of 189 patients were evaluated. 67.2% were male with a mean age of 59.4 (DE: 16,8) years old, 53 (28%) developed pressure ulcers, being the incidence rate of 41 ulcers per 1000 admission days. The mean day of diagnosis was 7.7 days (DE: 4,4) and the most frequent area was the sacrum. The sensitivity and specificity for the mean of observations was 94.34 (IC95% 87.17-100) and 33.33 (IC95% 25.01-41.66) for the EMINA scale for a risk > 10 and 92.45 (IC95% 84.40-100) and 42.96 (IC95% 34.24-51.68) for the EVARUCI scale for a risk of > 11. Conclusions: No differences were found in predictive capacity of both scales. For sensitivities > 90%the scales show to be insufficiently specific in the pressure ulcer risk detection in critical patients. (C) 2014 Elsevier Espana, S.L.U. and SEEIUC. All rights reserved.