Evaluation of the Predictive Capacity of the Braden Scale for Pressure Injury Development among Hospitalized Patients in Addis Ababa, Ethiopia

Abstract

Abstract Background: Effective prevention of pressure injuries relies on accurately predicting patient risk. International pressure injury prevention guidelines advocate the use of risk assessment tools like the Braden Scale. While the Braden Scale's predictive ability varies across studies, its effectiveness in the Ethiopian healthcare setting remains unexamined. Objective: The study aimed to investigate the predictive ability of the Braden in forecasting pressure injuries in hospitalized patients. Method: This prospective study enrolled 238 patients from critical care units in three public hospitals in Addis Ababa, Ethiopia, using convenience sampling. Data were collected using structured questionnaires and analyzed with SPSS version 25. Binary logistic regression assessed variable relationships, and ROC analysis evaluated the Braden Scale's predictive ability for pressure injuries. Results The study analyzed 229 participants, predominantly male (59.8%), with a median age of 39 years. The mean score on theBraden Scale was 13.2 ± 2.95on a scale of  6 – 23. Pressure injuries developed in 21.83% of participants. The Braden Scale score, age, and body temperature ware significant predictors of pressure injury risk. A one-unit increase in the Braden Scale score reduced injury odds by 24.5%, while age and body temperature increased the odds by 2% and 2.27 times, respectively. ROC analysis revealed a sensitivity of 64% and specificity of 59.2% at a cut-off point of 13.5. The AUC value was 0.682 (95% CI: 0.611, 0.761), reflecting a statistically significant, yet insufficient capacity to predict the risk of pressure injuries (p < 0.001). Conclusion: The Braden Scale score, body temperature, and age are significant predictors of pressure injuries. However, the results indicate that the Braden Scale has limited predictive ability in identifying hospitalized patients at risk of developing pressure injuries. Further research with a larger sample size in specific clinical settings is needed to fully evaluate its effectiveness. [Ethiop. J. Health Dev. 2025; 39(1)] Keywords: Braden Scale, Pressure Injury, ROC analysis, AUC, Sensitivity, Specificity