Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients

Jacob C. Jentzer, Nandan S. Anavekar, Jorge A. Brenes-Salazar, Brandon Wiley, Dennis H. Murphree, Courtney Bennett, Joseph G. Murphy, Mark T. Keegan, Gregory W. Barsness

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: 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. Patients and Methods: 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. Results: 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). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)1994-2003
Number of pages10
JournalMayo Clinic proceedings
Volume94
Issue number10
DOIs
StatePublished - Oct 1 2019

Fingerprint

Critical Care
Hospital Mortality
Skin
Mortality
Intensive Care Units
Comorbidity
Odds Ratio
Nursing Assessment
Tertiary Healthcare
Proportional Hazards Models
Tertiary Care Centers
Survivors
Cohort Studies
Retrospective Studies
Logistic Models
Pressure
Survival
Wounds and Injuries

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Jentzer, J. C., Anavekar, N. S., Brenes-Salazar, J. A., Wiley, B., Murphree, D. H., Bennett, C., ... Barsness, G. W. (2019). Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients. Mayo Clinic proceedings, 94(10), 1994-2003. https://doi.org/10.1016/j.mayocp.2019.04.038

Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients. / 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.

In: Mayo Clinic proceedings, Vol. 94, No. 10, 01.10.2019, p. 1994-2003.

Research output: Contribution to journalArticle

Jentzer, JC, Anavekar, NS, Brenes-Salazar, JA, Wiley, B, Murphree, DH, Bennett, C, Murphy, JG, Keegan, MT & Barsness, GW 2019, 'Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients', Mayo Clinic proceedings, vol. 94, no. 10, pp. 1994-2003. https://doi.org/10.1016/j.mayocp.2019.04.038
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. / Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients. In: Mayo Clinic proceedings. 2019 ; Vol. 94, No. 10. pp. 1994-2003.
@article{1b0d565b4fe044c5961c930a01b82242,
title = "Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients",
abstract = "Objective: 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. Patients and Methods: 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. Results: 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). Conclusion: 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.",
author = "Jentzer, {Jacob C.} and Anavekar, {Nandan S.} and Brenes-Salazar, {Jorge A.} and Brandon Wiley and Murphree, {Dennis H.} and Courtney Bennett and Murphy, {Joseph G.} and Keegan, {Mark T.} and Barsness, {Gregory W.}",
year = "2019",
month = "10",
day = "1",
doi = "10.1016/j.mayocp.2019.04.038",
language = "English (US)",
volume = "94",
pages = "1994--2003",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "10",

}

TY - JOUR

T1 - Admission Braden Skin Score Independently Predicts Mortality in Cardiac Intensive Care Patients

AU - Jentzer, Jacob C.

AU - Anavekar, Nandan S.

AU - Brenes-Salazar, Jorge A.

AU - Wiley, Brandon

AU - Murphree, Dennis H.

AU - Bennett, Courtney

AU - Murphy, Joseph G.

AU - Keegan, Mark T.

AU - Barsness, Gregory W.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Objective: 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. Patients and Methods: 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. Results: 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). Conclusion: 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.

AB - Objective: 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. Patients and Methods: 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. Results: 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). Conclusion: 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.

UR - http://www.scopus.com/inward/record.url?scp=85072397418&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072397418&partnerID=8YFLogxK

U2 - 10.1016/j.mayocp.2019.04.038

DO - 10.1016/j.mayocp.2019.04.038

M3 - Article

C2 - 31585582

AN - SCOPUS:85072397418

VL - 94

SP - 1994

EP - 2003

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 10

ER -