A Retrospective Randomized Study Comparing the Effectiveness of Using the Braden Scale to Predict Pressure Injuries (PrI) in Patients with Spinal Cord Injury (SCI) at an Outpatient Rehabilitation Center

The Braden Scale is a commonly used and validated outcome measure for pressure injury (PrI) prediction in the general population, particularly in hospitals and facilities. Our aim is to determine if it is an effective outcome measure to determine risk of PrI development in patients with spinal cord injuries (SCI) at an outpatient rehabilitation center.

A retrospective randomized chart review of patients with traumatic and nontraumatic SCI who participated in physical therapy from January 2015 to December 2017 was performed. A total of 79 patients were identified and were divided into two categories, “at risk” and “not at risk,” based on the Braden cut-off score of 18. Results indicate a higher incidence of patient-reported history of PrI and occurrence of PrI at initial evaluation in those with scores below 18. Furthermore, when separated into categories based on SCI classifications, those with tetraplegia and those with complete lesions are significantly more likely to have scores under the Braden cutoff. Preliminary research demonstrates that patients with scores below 18, when followed for three years, show a higher percentage of PrI development. This indicates that the Braden Scale might be an effective outcome measure for the SCI population to determine risk of PrI development in the outpatient rehabilitation setting. This study also suggests that within the SCI population, the Braden Scale is more effective at determining risk of PrI development in those with complete SCI and those with tetraplegia.

A prospective study should be used to further explore the effectiveness of this tool, perhaps to compare it against an outcome measure designed specifically for the rehabilitation setting. Better risk assessment tools can lead to improved quality of life and community integration for patients with SCI.