Incidence and risk factors for pressure ulcers in the intensive care unit
Incidence and risk factors for pressure ulcers in the intensive care unit
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DOI：
10.1111/j.1365-2702.2008.02554.x
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发表时间：
2009-05-01
影响因子：
4.2
通讯作者：
Van Den Berghe, Greet
中科院分区：
文献类型：
--
作者：
Nijs, Nele;Toppets, Adinda;Van Den Berghe, Greet
确定住院后至少48小时发生的压疮的发生率和长期住院的外科重症监护室（ICU）人群中2-4级压疮的危险因素。重症监护室中压疮的发生率大于非重症环境。前瞻性描述性研究设计。使用2-4级压疮作为结局指标，采用多因素Logistic回归分析确定危险因素。2003年11月至2004年3月期间，在鲁汶大学医院外科重症监护室每天获得数据。共纳入520例长期（>= 2 - 4小时）重症监护患者，2-4级压疮的累积发生率为20.1%。以下变量与2-4级压疮呈正相关：血管疾病史、多巴胺（（R））或多巴酚丁胺（（R））治疗、间歇性血液透析（IHD）或连续性静脉-静脉血液滤过（CVVH）、机械通气。此外，预防措施与2-4级压疮呈统计学正相关：翻身、漂浮脚跟、交替床垫、充分预防。使用镇静剂、体温高于38.5摄氏度和坐在椅子上与压疮有负相关。压疮与不同的危险因素和预防措施有统计学相关性。确定的危险因素有资格被纳入重症监护病房患者的新风险评估量表。新的见解对重症监护病房患者的风险评估有意义。入住重症监护室的患者有其他压疮风险因素，这些因素有资格纳入新的风险评估量表。
To determine the incidence of pressure ulcers occurring at least 48 hours after admission and risk factors for pressure ulcers grade 2-4 in a long-stay surgical Intensive Care Unit (ICU) population.The incidence of pressure ulcers in intensive care units is larger than in non-intensive environments.Prospective descriptive research design.Using pressure ulcers grade 2-4 as an outcome measure, a multivariate logistic regression analysis was used to identify the risk factors. Data were obtained on a daily basis in a surgical intensive care unit of the University Hospital Leuven between November 2003-March 2004. A total of 520 long-stay (>= 24 hours) intensive care patients were included.Cumulative incidence of pressure ulcers grade 2-4 was 20.1%. The following variables were positively associated with pressure ulcers grade 2-4: history of vascular disease, treatment with Dopamine((R)) or Dobutamine((R)), intermittent haemodialysis (IHD) or continuous veno-venous haemofiltration (CVVH), mechanical ventilation. Also preventive measures were statistically positively associated with pressure ulcers grade 2-4: turning, floating heels, alternating mattresses, adequate prevention. The use of sedatives, body temperature above 38.5 degrees C and sitting in chair where negatively associated with pressure ulcers. Pressure ulcers are statistically associated with different risk factors and preventive measures.The identified risk factors are eligible to be included in a new risk assessment scale for patients admitted to intensive care units.The novel insights have implications for risk assessment for patients in intensive care units. Patients admitted to intensive care units have other risk factors for pressure ulcers which are eligible to be included in a new risk assessment scale.