Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients? Yaşar Gökhan Gül 1 , Ali Şefik Köprülü 2 , Ali Haspolat 3 , Sinan Uzman 4 , Mehmet Toptaş 4 , İdris Kurtuluş 5 1 Bilgi University, School of Health Sciences, İstanbul, Turkey 2 Department of Anesthesiology and Reanimation, Yeni Yüzyıl University School of Medicine, İstanbul, Turkey 3 Clinic of Anesthesiology and Reanimation, Kolan International Hospital, İstanbul, Turkey 4 Clinic of Anesthesiology and Reanimation, Haseki Training and Research Hospital, İstanbul, Turkey 5 Department of Medical Services, Fatih Public Hospital Association General Secretariat, İstanbul, Turkey ABSTRACT Objective: To prevent pressure ulcer, detecting risk factors and planning how to act with respect to patients provide to find solution. Thus, Braden Scale is the most common tool that is used in Turkey. This study aimed to measure Braden Scale effectiveness at detecting the risk groups of level 3 intensive care unit patients. Methods: This prospective, single-center study includes 206 level 3 intensive care unit patients whose risk factors were standardized as much as possible in the intensive care unit between January 2014 and May 2015. Routine clinical care was applied to the patients whose risk groups were determined by Braden Scale, and the patients were divided into two groups depending on the presence of a pressure ulcer before discharging from the hospital. Demographic findings, hospitalization duration, mental status, Apache II score, expected/actual mortality, blood albumin levels, and Braden Scale score were compared. Results: Comparison of the groups showed that patients’ age, length of stay in intensive care unit, mental status, and blood albumin levels are significantly different between patients with and without pressure ulcers. Furthermore, scores of patients with pressure ulcers were not significantly different from those of patients without pressure ulcers. Data also illustrated that pressure ulcers occurred in no risk patients with the ratio of 7.14%; in low-risk patients with the ratio of 27.8%; in moderate-risk patients with the ratio of 29.73%; in high-risk patients with the ratio of 17.72%. Conclusion: Data evaluation demonstrates that Braden Scale is not effective to detect the risk factors, and parameters related to pressure ulcer development are not sufficiently represented by Braden Scale. Modification of an existing scale or a new risk assessment scale that includes all other risk parameters and that is more suitable for the patients of our country is required. (JAREM 2016; 6: 98-104) Keywords: Braden Risk Assessment Scale, pressure ulcer, intensive care unit 98 Original Investigation Received Date: 20.10.2015 Accepted Date: 16.12.2015 © Copyright 2016 by Gaziosmanpaşa Taksim Training and Research Hospital. Available on-line at www.jarem.org DOI: 10.5152/jarem.2016.969 Address for Correspondence: Dr. Yaşar Gökhan Gül, E-mail: doctorgul@yahoo.com INTRODUCTION Pressure ulcers are localized damages occurring in the skin and/ or subcutaneous tissues (1). This condition usually develops in the areas over bony prominences of the body depending on the exposure to constant pressure, peeling, and friction of the skin or combinations of these (1-3). The back of the head, shoulder head, elbow, lower back, hips, pelvic bone, ankle, and heel are the parts of the body where pressure ulcers are widely seen (4). The incidence of pressure ulcers in intensive care units is reported to be between 8.8% and 53.2% in different studies (5, 6). Pressure ulcers cause the patient to feel pain, delay the treatment of the primary disease, and reduce the quality of life after discharge. This situation is an important health problem that increases treat- ment costs and reduces patient comfort, and it is a major health problem, particularly in countries with limited resources allocated to health in terms of the global budget (7, 8). Determining the situation and developing the action plans for patients by determining the possible risk groups directly contrib- ute to resolving the problem in terms of the prevention of pres- sure ulcers. The scale that is still most commonly used in Turkey and in many other countries and that is said to be the most reli- able and valid scale for patient groups of a wide age range is the “Braden Risk Assessment Scale (BRDs)” (8-14). In this study, we aimed to determine the validity of the Braden Scale in determining the risk groups of pressure ulcers in level 3 patients treated in the intensive care unit (ICU). METHODS In total, 206 level 3 patients who met the following parameters in the intensive care unit between January 2014 and May 2015 were included in our prospective, single-center study: - Those who were over 18 years of age, - Those who had a body mass index (BMI) between 18.5 and 24.9, - Those who had taken at least 120 hours of mechanical ventila- tion treatment,