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A regression analysis of the Waterlow score in pressure ulcer risk assessment

Mary Seacole Research Centre, School of Nursing & Midwifery, De Montfort University, Leicester; danthony{at}dmu.ac.uk

Tim Reynolds

Department of Chemical Pathology, Queen's Hospital, Burton on Trent, Staffordshire, UK

Linda Russell

Queen's Hospital, Burton on Trent, Staffordshire, UK

Objective: To explore the predictive value of the Waterlow score, and the subscores of age and gender.

Design: Logistic regression analysis was conducted on the two subscores of the Waterlow score, and the residual Waterlow score with gender and age removed. Receiver operating characteristic (ROC) analysis gave a quantitative measure of the classification ability of the Waterlow score.

Setting: Burton, UK. Subjects: All admissions over a five-year period to the District General Hospital, a total of 150 015 admissions of 82 691 patients.

Interventions: None.

Main outcome measures: Area under the ROC curve for significant (as determined by logistic regression) variables.

Results: Data were inaccurate in at least 44.7% of the records, and analysis was conducted on the 43 735 records for which no errors were apparent. Nine hundred and fifty-four patients had a pressure ulcer on admission (2.1%); 277 developed a pressure ulcer (0.6%). The Waterlow score was predictive of pressure ulcers. Age was predictive, and gender was not found to be a significant predictor.

Conclusions: The Waterlow score may be improved and simplified by removing gender from the scoring system.

Clinical Rehabilitation, Vol. 17, No. 2, 216-223 (2003)
DOI: 10.1191/0269215503cr603oa


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