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A regression analysis of the Waterlow score in pressure ulcer risk assessment
Denis Anthony1, Tim Reynolds, Linda Russell
1Mary Seacole Research Centre, School of Nursing & Midwifery, De Montfort University, Leicester, UK. danthony@dmu.ac.uk
Objective:
To explore the predictive value of the Waterlow score, and the subscores of age and gender.
Design:
Logistic regression analysis was conducted on the two subscores of the Waterlow score, and the residual Waterlow score with gender and age removed. Receiver operating characteristic (ROC) analysis gave a quantitative measure of the classification ability of the Waterlow score.
Setting:
Burton, UK.
Subjects:
All admissions over a five-year period to the District General Hospital, a total of 150,015 admissions of 82,691 patients.
Interventions:
None.
Main Outcome Measures:
Area under the ROC curve for significant (as determined by logistic regression) variables.
Results:
Data were inaccurate in at least 44.7% of the records, and analysis was conducted on the 43,735 records for which no errors were apparent. Nine hundred and fifty-four patients had a pressure ulcer on admission (2.1%); 277 developed a pressure ulcer (0.6%). The Waterlow score was predictive of pressure ulcers. Age was predictive, and gender was not found to be a significant predictor.
Conclusions:
The Waterlow score may be improved and simplified by removing gender from the scoring system.