FreshRSS

🔒
☐ ☆ ✇ Journal of Clinical Nursing

Assessing the Risk of Delirium and Death in Sepsis Using the Braden Score: A Retrospective Study

Por: Xinya Li · Yonglan Tang · Zihong Bai · Xin Liang · Xiaxuan Huang · Jianguang Chen · Hongtao Cheng · Jun Lyu · Yu Wang — Octubre 12th 2024 at 05:30

ABSTRACT

Aims and Objectives

To provide a viable tool for the early clinical identification of high-risk populations in patients with sepsis.

Background

Sepsis-associated delirium (SAD) has the potential to significantly impact the short- and long-term prognosis of patients. However, accurately predicting and effectively managing SAD remains a significant challenge.

Methods

This study employed a retrospective analysis of adult sepsis patients admitted to the intensive care unit (ICU) for the first time. Patients were divided into two groups based on their initial Braden score upon admission to the ICU: a high-risk group (≤ 15 points) and a low-risk group (> 15 points). The relationship between Braden score and delirium was assessed using logistic regression and restricted cubic splines, while restricted mean survival time was employed to analyse the relationship between Braden scores and patients' 90- and 180-day mortality.

Results

Of the 28,312 patients included in the study, those in the high-risk group exhibited a significantly elevated risk of delirium (44.8% vs. 29.7%) and higher 90-day (28.7% vs. 19.4%) and 180-day (33.2% vs. 24.1%) mortality rates (all p < 0.001). After adjusting for confounding variables, logistic regression demonstrated that the risk of delirium was 1.54 times higher in the high-risk group (95% CI = 1.45–1.64, p < 0.001). Following propensity score matching, the difference in survival was statistically significant at both time points, with the high-risk group having a reduced survival rate of 7.50 days (95% CI = −8.24, −6.75; p < 0.001) and 15.74 days (95% CI = −17.40, −14.08; p < 0.001) at 90 days and 180 days, respectively.

Conclusions

The Braden score is a simple and effective tool for the early identification of patients at increased risk of adverse outcomes in sepsis.

Design

Retrospective study.

Relevance to Clinical Practice

The Braden score can be employed by clinical nurses for the purpose of early identification of poor prognostic risk in patients with sepsis.

Reporting Method

This study was conducted according to the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.

Patient or Public Contribution

Patients were involved in the sample of the study.

☐ ☆ ✇ International Wound Journal

Comparative efficacy of silver alginate dressings versus standard gauze in enhancing wound healing post‐mastectomy for triple‐negative breast cancer: A systematic review and meta‐analysis

Por: Kejiao Qiang · Hong Jiang · Yuanyuan Xing · Xin Liang · Yangfei Luo · Xiao Wu — Diciembre 29th 2023 at 06:23

Abstract

This meta-analysis evaluates the efficacy of silver alginate dressings (SAD) compared to standard gauze (SG) in enhancing wound healing and reducing scar formation post-mastectomy in patients with triple-negative breast cancer. From an initial pool of 1245 articles, five studies met the inclusion criteria. The analysis revealed that SAD significantly improve early wound healing 1 week post-mastectomy, as indicated by lower Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scales (I 2 = 85%; Random: SMD: −7.08, 95% CI: −8.26 to −5.98, p < 0.01), compared to SG. Additionally, long-term scar outcomes measured by the Manchester Scar Scale (MSS) 5 months post-mastectomy showed a notable reduction in scar formation (I 2 = 95%; Random: SMD: −12.97, 95% CI: −16.20 to −9.75, p < 0.01)) in the silver alginate group. The findings support the use of SAD in post-mastectomy care for triple-negative breast cancer patients but highlight the need for further research on long-term safety and cost-effectiveness.

❌