Predicting pressure sore risk with the Norton, Braden, and Waterlow scales in a Hong Kong rehabilitation hospital

Background: Numerous pressure sore risk calculators have been developed since the 1960s. Each scale is claimed to have predictive value and applicability in various clinical settings, but it has not been determined which one is more relevant for adoption in a rehabilitation setting. Objectives: To compare the predictive power of the three most commonly adopted pressure sore risk calculators: Norton, Braden, and Waterlow scales. Method: One hundred six patients, free of pressure sores at Braden, and Waterlow scales. admission, were assessed using the three scales by independent assessors within 48 hours of admission, followed by a daily monitoring of skin condition for at least 14 days to detect any sore that developed. Results: Both the Norton and Waterlow scales had relatively high sensitivity (81% and 95%, respectively), whereas the Braden Scale had both high sensitivity (91%) and specificity (62%). All three scales had relatively high negative predictive values (>90%), but the Braden Scale had better positive predictive value. Conclusions: The Braden Scale is more suitable for use in a rehabilitation hospital.