Predicting delayed healing: The diagnostic accuracy of a venous leg ulcer risk assessment tool

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Edwards, Helen E
Parker, Christina N
Miller, Charne
Gibb, Michelle
Kapp, Suzanne
Ogrin, Rajna
Anderson, Jacinta
Coleman, Kerrie
Smith, Dianne
Finlayson, Kathleen J
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2018
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Abstract

The aim of this study was to validate a newly developed tool that can predict the risk of failure to heal of a venous leg ulcer in 24 weeks. The risk assessment tool was validated, and performance of the tool was assessed using Area Under the Receiver Operating Characteristic Curve (AUC) analysis. Retrospective and prospective validation was conducted through multi-site, longitudinal studies. In the retrospective study (n = 318), 30% of ulcers did not heal within 24 weeks, with the tool demonstrating an AUC of 0.80 (95% CI, 0.68-0.93, P <.001) for the total score. In the prospective study across 10 clinical sites (n = 225), 31% (n = 68) of ulcers did not heal within 24 weeks. Participants were classified with the RAT at enrolment as being at low risk (27%), moderate risk (53%) or high risk (20%) of delayed healing; the proportion of wounds unhealed at 24 weeks was 6%, 29% and 59%, respectively. Validation results of the total score indicated good discrimination and goodness of fit with an AUC of 0.78 (95% CI, 0.71-0.85, P <.001). Validation of this risk assessment tool offers assurance that realistic outcomes can be predicted for patients, and scores can guide early decisions on interventions to address specific risk factors for failing to heal, thus promoting timely healing.

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International Wound Journal

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15

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2

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Clinical sciences

Nursing

Science & Technology

Life Sciences & Biomedicine

Dermatology

Surgery

delayed healing

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Edwards, HE; Parker, CN; Miller, C; Gibb, M; Kapp, S; Ogrin, R; Anderson, J; Coleman, K; Smith, D; Finlayson, KJ, Predicting delayed healing: The diagnostic accuracy of a venous leg ulcer risk assessment tool, International Wound Journal, 2018, 15 (2), pp. 258-265

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