Pressure injuries in stroke patients: a comparison of the predictive abilities of Braden, Waterlow and Jackson/Cubbin risk assessment scales

Pressure injuries (PIs) are common complications of stroke and pose a significant threat to patient safety. Risk assessment scales are essential tools for evaluating and quantifying potential risk factors, identifying high-risk individuals, improving patient prognosis, and enhancing the overall quality of care. This study aimed to compare the predictive validity, discrimination and accuracy of the Braden, Waterlow and Jackson/Cubbin scales in assessing the risk of PIs in stroke patients. Method: A prospective observational study was conducted in a neurology ward between November 2022 and October 2023. The Braden, Waterlow and Jackson/Cubbin scales were used to assess patients independently within eight hours of admission and daily thereafter. Results: Among the 567 patients included, 37 (6.53%) developed PIs during hospitalisation. The Braden scale demonstrated a sensitivity of 70.27%, specificity of 69.81%, and an area under the receiver operating characteristic curve (AUC) of 0.73. Sensitivity, specificity and AUC values for the Waterlow scale were 89.19%, 67.17% and 0.82, respectively, while the Jackson/Cubbin scale showed values of 81.08%, 56.23% and 0.70, respectively. In terms of discrimination, pairwise comparisons of the AUC revealed that the Waterlow scale outperformed the Braden scale (Z=2.828; p