Background
The Braden Skin Score(BSS) is a ubiquitous bedside nursing assessment tool used to screen for pressure injury risk. Lower BSS (higher risk of pressure injury) is associated with increased mortality, increased length of stay(LoS) and decreased likelihood of discharge home in subgroups of hospitalised patients.
Aims
To investigate correlation between BSS and clinical frailty scale(CFS), functional independence measure(FIM), LoS, and discharge destination in older patients admitted to Geriatric Evaluation and Management(GEM) units.
Methods
A retrospective chart audit of patients admitted to GEM units was conducted at Kingston Centre, Monash Health over 3 months. CFS was calculated retrospectively using clinical documentation. Patients under 65 years old, or missing BSS or FIM scores were excluded from the study.
Results
The study included 189 patients (mean age 82±8 years). Median admission and discharge scores were: BSS 17 (IQR 15,19) and 18 (16,19); FIM, 61 (45,75) and 87 (64,105); CFS, 5 (4,6) and 6 (5,7) respectively. Admission BSS had (a) positive moderate-correlation with Discharge FIM (rho 0.48, p<0.001), (b) negative moderate-correlation with Discharge CFS (rho -0.43,p <0.001) and (c) negative weak-correlation with LoS (rho -0.37,p <0.001). Premorbidly, 88% of patients were from home and 3% were from residential-aged- care-facilities(RACF). At discharge, 56% returned home, 30% were discharged to RACF and 4% died.
Conclusion
This study suggests that BSS could be a surrogate marker of frailty and predict outcomes such as LoS and discharge disposition. Future research should address whether these findings can be replicated in cohorts other than GEM patients