• Jacob Higgins, Sherri Casey, Erin Taylor, Riley Wilson, and Paula Halcomb.
• Jacob Higgins is an assistant professor, University of Kentucky College of Nursing, and a nurse-scientist, UK HealthCare, Lexington, Kentucky.
• Crit Care Nurse. 2020 Dec 1; 40 (6): 52-61.

BackgroundThe occurrence of pressure injury in the critical care environment has multiple risk factors. Prevention requires reliable assessment tools to help predict injury risk. The Braden scale, a commonly used risk assessment tool, has been shown to have poor predictive properties in critical care patients. The Jackson/Cubbin scale was developed specifically for pressure injury risk stratification in critically ill patients and has demonstrated acceptable predictive properties in the general critical care population but has not been examined in critically ill trauma-surgical patients.ObjectiveTo compare the predictive properties of the Braden and Jackson/Cubbin scales in a trauma-surgical critical care population.MethodsA retrospective medical records review was performed to evaluate the clinical characteristics of 366 trauma-surgical critical care patients. Additionally, the negative predictive value, positive predictive value, sensitivity, specificity, and receiver operating characteristic curve with area under the curve of the Braden and Jackson/Cubbin scales were determined.ResultsThe sample consisted of primarily middle-aged (mean [SD], 56 [19] years) men (64%) admitted after trauma (71%). The participants who developed pressure injuries were older, more often required vasopressors and mechanical ventilation, and were less mobile. Predictive properties for the Braden and Jackson/Cubbin scales, respectively, were as follows: negative predictive value, 78% versus 87%; positive predictive value, 53% versus 66%; sensitivity, 17% versus 54%; specificity, 95% versus 92%; and area under the curve, 0.710 versus 0.793.ConclusionThe Jackson/Cubbin scale demonstrated superior predictive properties and discrimination compared with the Braden scale for pressure injury risk prediction in critically ill trauma-surgical patients.©2020 American Association of Critical-Care Nurses.

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