Braden Skin Score predicts mortality in cardiac intensive care patients

The Braden Skin Score (BSS) quickly and noninvasively identifies poor outcomes in patients admitted to the cardiac intensive care unit (CICU), a study has shown. BSS subdomains with a robust association with mortality appear to indicate physical frailty.

“Insofar as the BSS and its subscores measure frailty, a low BSS may identify frail patients,” according to the investigators.

This retrospective cohort study was conducted to examine the association between each of the six individual BSS subscores with hospital mortality in patients admitted to the Mayo Clinic CICU from 2007 to 2018 with BSS documented on admission. The investigators posited that BSS subscores reflecting patient frailty would correlate strongly with outcomes.

All-cause hospital mortality was the primary outcome. The investigators used multivariable logistic regression to determine the odds ratios (ORs).

A total of 11,954 patients (mean age 67.4 years, 37.8 percent women) were included. Each individual BSS subscore was found to be lower among patients who died in the hospital (p<0.001 for all).

Across admission diagnoses and among patients with coma or mechanical ventilation, the total BSS inversely correlated with in-hospital mortality. Each individual subscore showed an inverse association with in-hospital mortality.

Multivariate analysis revealed the inverse correlation of all subscores with hospital mortality after full adjustment. Shear showed the most robust association (adjusted OR, 0.59), followed by nutrition (adjusted OR, 0.67), skin moisture (adjusted OR, 0.76), mobility (adjusted OR, 0.76), sensory perception (adjusted OR, 0.82), and activity level (adjusted OR, 0.85).

“The BSS is a bedside nursing assessment that may be a measure of frailty and predicts mortality among patients in the cardiac CICU,” the investigators said.