Abstract
Background
The Braden Skin Score (BSS) is a bedside nursing assessment that may be a measure
of frailty and predicts mortality among patients in the cardiac intensive care unit
(CICU). We examined the association between each of the 6 individual BSS subscores
with hospital mortality in patients in the CICU. We hypothesized that BSS subscores
reflecting patient frailty would have a stronger association with outcomes.
Methods
Retrospective cohort study of unique adult patients admitted to the Mayo Clinic CICU
from 2007 to 2018 with BSS documented on admission. Primary outcome was all-cause
hospital mortality. Odds ratios (ORs) were determined using multivariable logistic
regression.
Results
The 11,954 included patients had a mean age of 67.4 ± 15.2 years (37.8% women). Each
individual BSS subscore was lower among patients who died in the hospital (all P < .001). The total BSS was inversely associated with in-hospital mortality across
admission diagnoses and among patients with coma or mechanical ventilation; each individual
subscore was inversely associated with in-hospital mortality. On multivariable regression,
all subscores were inversely associated with hospital mortality after full adjustment.
Shear had the strongest association (adjusted OR 0.59), followed by nutrition (adjusted
OR 0.67), skin moisture (adjusted OR 0.76), mobility (adjusted OR 0.76), sensory perception
(adjusted OR 0.82), and activity level (adjusted OR 0.85).
Conclusion
BSS can serve as a rapid noninvasive screening tool for identifying poor outcomes
in patients in the CICU. BSS subdomains that are more strongly associated with mortality
appear to reflect physical frailty. Insofar as the BSS and its subscores measure frailty,
a low BSS may identify frail patients.
Keywords
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Article Info
Publication History
Published online: February 21, 2022
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
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