Comparison of the EVARUCI and Braden scales as predictors of pressure injuries in critically ill patients

Vásquez-Tirado G.A.; Reyes-Cortegana C.J.; Reyes-Escudero J.E.; Meregildo-Rodríguez E.D.; Quispe-Castañeda C.V.; Ortiz-Pizarro M.; Abanto-Montalván P.H.; Guzmán-Aguilar W.M.; Serna-Alarcón V. · Piel (2026) · DOI: 10.1016/j.piel.2025.07.015

Resumen

Introduction Pressure injuries (PI) in critically ill patients represent a serious concern and serve as a quality indicator in health care. It is crucial not only to prevent them but also to assess the risk of their occurrence using simple, reliable scales. The aim of this study was to determine whether the EVARUCI scale offers superior predictive performance for PI compared to the Braden scale in critically ill patients. Methods We conducted a cohort study including 124 patients without PI upon admission to the Intensive Care Unit (ICU) of the Regional Teaching Hospital of Trujillo (HRDT), Trujillo, Peru, between 2019 and 2023. Patients were followed for up to 30 days of hospitalization. Results Overall, 40.32% of the critically ill patients developed pressure injuries. Among those affected, the mean age was 56.44 years and 52% were male. All patients who developed PI were classified as high risk by the Braden scale, and 96% were classified as high risk by the EVARUCI scale. In the relative risk analysis, the EVARUCI score was associated with a markedly increased risk of PI (adjusted RR = 26.40; 95% CI: 5.90–118.13; p = 0.01), whereas the Braden score also showed a significant association (adjusted RR = 4.52; 95% CI: 2.27–7.32; p = 0.01). Finally, receiver operating characteristic (ROC) curve analysis yielded an area under the curve (AUC) of 0.817 (95% CI: 0.74–0.88) for EVARUCI and 0.824 (95% CI: 0.75–0.89) for Braden. Conclusions Both the EVARUCI and Braden scales are adequate predictors of pressure injuries. However, when directly compared, the EVARUCI scale demonstrated superior predictive performance in critically ill patients.

Instituciones: Universidad Nacional de Trujillo; Universidad Privada Antenor Orrego; Universidad Señor de Sipán; Universidad Católica Santo Toribio de Mogrovejo