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Contrast-Enhanced Subharmonic Aided Pressure Estimation SHAPE Using Ultrasound Imaging with a Focus on Identifying Portal Hypertension

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Published on: December 5, 2020

The Shieh Score as a Risk Assessment Tool for Hospital-Acquired Pressure Injuries: A Retrospective Cohort Study.

David Shieh¹, Qiaowu Li, Jiaxiao M Shi

¹At Kaiser Permanente, Pasadena, California, David Shieh, MD, is Internal Medicine Physician; Qiaowu Li, MS, is Biostatistician; Jiaxiao M. Shi, PhD, is Research Biostatistician; and Stephanie Tovar, MS, is Clinical Trials Research Project Manager. The authors have disclosed no financial relationships related to this article. Submitted April 5, 2020; accepted in revised form June 29, 2020.

Advances in Skin & Wound Care

|February 15, 2021

Summary

A new tool, the Shieh Score, effectively identifies patients at high risk for hospital-acquired pressure injuries. It offers higher specificity and positive predictive value compared to the Braden Scale for pressure injury prevention.

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Area of Science:

Clinical assessment tools
Patient safety
Healthcare quality improvement

Background:

Hospital-acquired pressure injuries (HAPIs) pose a significant patient safety concern.
Accurate risk assessment is crucial for preventing HAPIs.
Existing tools like the Braden Scale have limitations in specificity and positive predictive value.

Purpose of the Study:

To develop and validate a novel risk assessment tool, the Shieh Score, for identifying patients at high risk of HAPIs.
To compare the performance of the Shieh Score against the established Braden Scale.

Main Methods:

Retrospective analysis of 406,032 hospital admissions (2014-2016) with 1,299 pressure injury cases.
Development of the Shieh Score using decision tree and logistic regression to select key predictors.
Inclusion of demographic and clinical variables such as sex, age, diabetes, GFR, albumin, functional status, IV norepinephrine, mechanical ventilation, and consciousness level.

Main Results:

The Shieh Score incorporates nine key clinical and demographic factors.
The Shieh Score demonstrated a higher Youden Index, specificity, and positive predictive value than the Braden Scale.
The Braden Scale exhibited higher sensitivity in identifying at-risk patients compared to the Shieh Score.

Conclusions:

The Shieh Score serves as a valuable alternative risk assessment tool for HAPIs.
It effectively identifies a targeted group of high-risk patients with enhanced specificity and positive predictive value.
The Shieh Score aids in optimizing resource allocation for pressure injury prevention strategies.