Association between Braden Scale and all-cause mortality in critically ill patients with non-traumatic subarachnoid hemorrhage: analysis of the MIMIC-IV database

The Braden Scale (BS) is a routine nursing measure used to predict the risk of pressure ulcer events; recent studies suggest its use as a tool for identifying frailty. However, it remains unclear whether the BS holds prognostic value for patients with severe non-traumatic subarachnoid hemorrhage (SAH). In this retrospective study, participants from the Medical Information Mart for Intensive Care (MIMIC-IV) database were categorized into two groups based on their Braden Scale (BS) scores: the high-risk group (BS ≤ 15) and the low-risk group (BS > 15). The primary outcome was all-cause mortality at 3 months. A Cox proportional hazards model was constructed to examine the association between BS and all-cause mortality in critically ill patients with non-traumatic subarachnoid hemorrhage. A restricted cubic spline model was employed to assess the relationship between BS and outcomes. A total of 750 patients were included in the study, with 43% being male. The mortality rates at 1 month, 3 months, and 1 year were 21%, 25%, and 29%, respectively. Multivariable Cox proportional hazards analysis revealed that the Braden Scale (BS) was independently associated with the risk of death at 1 month (HR, 2.84 [1.26-2.81], P=0.002 ), 3 months (HR, 2.84 [1.73-4.66], P<  0.001), and 1 year (HR, 1.65 [1.15-2.38], P = 0.006). The restricted cubic spline regression model showed that the risk of death at 3 months increased linearly with decreasing BS scores. The BS is significantly associated with all-cause mortality in critically ill patients with non-traumatic SAH. This finding suggests that the BS may be useful in identifying non-traumatic SAH patients at higher risk of all-cause mortality.