Waterlow score

Last reviewed 01/2018

The Waterlow score permits patients to be classified according to their risk of developing a pressure sore (1).

The categories of risk factors are listed below:

  • weight for height
  • continence
  • skin condition
  • mobility
  • sex and age
  • appetite
  • special risks:
    • tissue condition and perfusion
    • neurological dysfunction
    • major surgery or trauma
    • medication

The score in each section is summated to give the overall score which indicates the relative risk:

  • 0-9 - low risk
  • 10-14 - at risk
  • 15-19 - high risk
  • 20+ - very high risk

A systematic review found that the Waterlow score offers a high sensitivity score (82.4%), but low specificity (27.4%), in the risk assessment of pressure ulcers (2).


  1. Edwards M. The levels of reliability and validity of the Waterlow pressure sore risk calculator. Journal of Wound Care 1995;4( 8): 373– 378.
  2. Pancorbo-Hidalgo PL et al. Risk assessment scales for pressure ulcer prevention: a systematic review. J Adv Nurs. 2006 Apr;54(1):94-110.