改良版Munro围术期成人压疮风险评估量表在手术患者压疮评估中的预测性研究

Predictive study of modified Munro pressure ulcer risk assessment scale for adult perioperative surgical patients

摘要:

目的：评价改良版Munro围术期成人压疮风险评估量表（Munro量表）对手术患者发生压疮风险的预测效度。方法：首先对Munro量表进行翻译、回译和调试，然后采用前瞻性队列研究设计方法，在重庆市两家三甲医院手术室选取246名手术患者进行评分并记录压疮发生情况。评估压疮实际发生率，计算尤登指数确定最佳预测临界值，计算受试者工作特征（receiver operating characteristic，ROC）曲线下AUC面积，计算量表的灵敏度、特异度、阳性预测值、阴性预测值。结果：实际发生压疮17例，压疮发生率为6.9%；Munro量表的ROC曲线下面积AUC=0.715（95%CI=0.586～0.844，P=0.003）；量表最佳预测临界值为29.5分时，尤登指数取得最大值为0.387，此时，灵敏度和特异度分别为0.588和0.799，阳性预测值和阴性预测值分别为0.178和0.963。结论：改良版Munro量表对围术期手术患者发生压疮风险的预测效度一般，有待进一步改进与完善，但目前仍可作为手术患者的压疮风险评估工具。

Abstract:

Objective：To evaluate the predictive validity of modified Munro pressure ulcer risk assessment scale（Munro scale） for adult perioperative surgical patients. Methods：Firstly，the scale and made cultural adaptation by Brislin’s translation model was translated. Then the prospective cohort study design was adopted，totally 246 surgery patients in two hospitals were recruited by convenience sampling method and investigated by the scales. Results：Seventeen patients（6.9%） developed pressure ulcer. Area under receiver operating characteristic curve was 0.715（95%CI=0.586 to 0.844，P=0.003）. The cutoff score of modified Munro scale was 29.5 for the risk of pressure ulcer，with the sensitivity of 0.588，specificity of 0.799，PPV of 0.178 and NPV of 0.963. Conclusion：The predictive validity of modified Munro scale for perioperative surgical patients with adult is ordinary，and there is room for improvement，but now it could be used to assess pressure ulcer risk of surgical patients.