Risk factors related to the development of pressure ulcers in the critical care setting
Risk factors related to the development of pressure ulcers in the critical care setting
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DOI：
10.1111/j.1365-2702.2009.03047.x
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发表时间：
2010-02-01
影响因子：
4.2
通讯作者：
Sanada, Hiromi
中科院分区：
文献类型：
--
作者：
Kaitani, Toshiko;Tokunaga, Keiko;Sanada, Hiromi
瞄准本研究确定了入院早期压疮发生的危险因素，以确定在入院早期可以进行哪些适当的干预措施来降低压疮发生的风险。在发生压疮的患者中，8-40%发生在重症监护环境中。因此，压疮的发展是一个常见的问题。前瞻性队列研究。研究机构是一家拥有606张床位的三级护理医院。对2003年4月16日至2003年7月15日入住重症监护室（ICU）或高级监护室（HCU）的98例患者进行了最终分析。患者平均年龄为62.3（SD 16.1）岁，观察期间本研究中压疮的发生率为11.2%。多因素分析显示，“急诊ICU/HCU患者”和“不常翻身”与压疮发生有关。压疮患者的翻身和重新定位次数显著减少（OR = 0.452，95%CI：0.212-0.966），p < 0.05。ICU/HCU患者压疮发生率明显低于急诊ICU/HCU患者（OR = 0.041 [95%CI：0.004-0.470]，p < 0.01）。压疮发展与APACHE II评分或任何影响皮肤完整性的药物之间没有关系。翻身和复位的频率以及急诊进入ICU/HCU的患者可以作为重症监护环境中开发评分系统的预后指标。这些直接进入ICU或HCU的患者属于高危人群，需要采取进一步的预防措施。
Aim. This study identified risk factors for pressure ulcer development early in the admission stage to determine what appropriate interventions might be conducted early in the admission stage to decrease the risk of pressure ulcer development.Background. Among patients who develop pressure ulcers, 8-40% of them occur in a critical care setting. Therefore, the development of pressure ulcers is a common problem.Design. Prospective cohort study.Methods. The study facility was a 606-bed tertiary care hospital. Ninety eight patients admitted to the intensive care unit (ICU) or the high care unit (HCU) from 16 April 2003-15 July 2003 were evaluated in the final analysis.Results. The mean patient age was 62.3 (SD 16.1) years, and the incidence of pressure ulcers in this study was 11.2% during the observation period. Multivariate analysis showed that 'emergency ICU/HCU patients' and 'infrequent turning' were related to pressure ulcer development. Patients with pressure ulcers experienced significantly fewer turns and repositionings (OR = 0.452, 95% CI: 0.212-0.966], p < 0.05. Fewer pressure ulcers developed in scheduled ICU/HCU patients than in emergency ICU/HCU patients (OR = 0.041 [95% CI: 0.004-0.470], p < 0.01).Conclusion. There was no relationship between pressure ulcer development and APACHE II score, or any medication that affected skin integrity. The frequency of turning and repositioning and patients with an emergency admission to the ICU/HCU can be the prognostic indicators for developing scoring system in critical care settings.Relevance to clinical practice. These patients admitted directly to ICU or HCU were in a high risk group, further preventive strategies will be required.