Predictive validity of weekly monitoring of wound status using DESIGN-R score change for pressure ulcer healing: A multicenter prospective cohort study

Shinji Iizaka, Hiromi Sanada, Yuko Matsui, Masutaka Furue, Takao Tachibana, Takeo Nakayama, Junko Sugama, Katsunori Furuta, Masahiro Tachi, Keiko Tokunaga, Yoshiki Miyachi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

There are few studies on predictive validity of methods to monitor the healing process of pressure ulcers. We evaluated whether the change of DESIGN-R (rating) score could predict subsequent healing, and determined the optimal cutoff points. In a multicenter prospective cohort study, patients were followed until wound healing or censoring. Wound severity was evaluated by the DESIGN-R tool every week, and the score change was calculated over 1-4 weeks (n = 411, 286, 224, and 170, respectively). In the multivariate analyses stratified by depth, a one-point improvement in DESIGN-R score over any period was positively associated with healing within the next 30 days independent of initial wound severity (hazard ratios over each 1-4 weeks ranging from 1.16 to 1.33 for superficial ulcers and from 1.21 to 1.27 for deep ulcers; all p < 0.05). The optimal cutoff points over 1-4 weeks were set as negative change for superficial ulcers and as positive change of ≥two points for deep ulcers. Nonhealing rate was higher for ulcers with DESIGN-R score change below the cutoff points than that aforementioned for both depths. Weekly monitoring by the DESIGN-R tool will be advantageous for evaluating prognosis of pressure ulcers independent of initial wound severity and depth.

Original languageEnglish
Pages (from-to)473-481
Number of pages9
JournalWound Repair and Regeneration
Volume20
Issue number4
DOIs
Publication statusPublished - Jul 1 2012

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Pressure Ulcer
Ulcer
Cohort Studies
Prospective Studies
Wounds and Injuries
Wound Healing
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Dermatology

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Predictive validity of weekly monitoring of wound status using DESIGN-R score change for pressure ulcer healing : A multicenter prospective cohort study. / Iizaka, Shinji; Sanada, Hiromi; Matsui, Yuko; Furue, Masutaka; Tachibana, Takao; Nakayama, Takeo; Sugama, Junko; Furuta, Katsunori; Tachi, Masahiro; Tokunaga, Keiko; Miyachi, Yoshiki.

In: Wound Repair and Regeneration, Vol. 20, No. 4, 01.07.2012, p. 473-481.

Research output: Contribution to journalArticle

Iizaka, Shinji ; Sanada, Hiromi ; Matsui, Yuko ; Furue, Masutaka ; Tachibana, Takao ; Nakayama, Takeo ; Sugama, Junko ; Furuta, Katsunori ; Tachi, Masahiro ; Tokunaga, Keiko ; Miyachi, Yoshiki. / Predictive validity of weekly monitoring of wound status using DESIGN-R score change for pressure ulcer healing : A multicenter prospective cohort study. In: Wound Repair and Regeneration. 2012 ; Vol. 20, No. 4. pp. 473-481.
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