A PROSPECTIVE-STUDY OF PRESSURE SORE RISK AMONG INSTITUTIONALIZED ELDERLY
A PROSPECTIVE-STUDY OF PRESSURE SORE RISK AMONG INSTITUTIONALIZED ELDERLY
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DOI：
10.1111/j.1532-5415.1992.tb01845.x
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发表时间：
1992-08-01
影响因子：
6.3
通讯作者：
BRADEN, B
中科院分区：
文献类型：
--
作者：
BERGSTROM, N;BRADEN, B
目的：确定饮食摄入、营养状况和其他身体指标是否是老年人压疮发生的危险因素。设计：队列研究。设置：250张床位的专业护理机构，90张延长护理床位，平均住院时间为28天。患者：200名新入院的居民（70%女性，95%白人）年龄超过65岁，估计停留> 10天，有压疮发生的风险（Braden量表评分小于或等于17）但没有现有压疮的患者进行12周的研究或直至出院。每周对皮肤评估、Braden量表评分、血压、体温、人体测量和饮食摄入进行研究。CBC，血清白蛋白，血清总蛋白，血清铁，铁结合力，血清锌和铜，血清维生素C进行了研究，每周为4周，每两周为8 wk.Main Outcome Measures：Presence/absence and stage of pressure sores.Main Results：Stage I pressure sores developed in 70（35%）and Stage 2 or worse in 77（38.5%）residents。发生压疮的受试者年龄较大（P < 0.001），收缩压和舒张压较低（P < 0.001），体温高于无压疮的受试者（P < 0.001）。患压疮的受试者的所有营养素的饮食摄入量都较低。使用Logistic回归，最好的预测或压疮的发展是Braden量表评分，舒张压，温度，膳食蛋白质摄入量，和age.Conclusions：建议入院后的第一个月的护理之家和每周的风险评估。风险状态可以通过使用布雷登量表结合年龄，血压，体温和膳食蛋白质摄入量的知识来有效预测。
Objective: To determine if dietary intake, nutritional status, and other physical markers are risk factors for the development of pressure sores in the elderly.Design: Cohort study.Setting: 250-bed skilled nursing facility with 90 extended care beds in which the average length of stay is 28 days.Patients: Two hundred newly admitted residents (70% female, 95% Caucasian) who were over age 65, estimated to stay > 10 days, at risk for pressure sore development (Braden Scale score less-than-or-equal-to 17) but free of existing pressure sores were studied for 12 weeks or until discharge.Measures: Skin assessment, Braden Scale score, blood pressure, body temperature, anthropometrics, and dietary intake were studied weekly. CBC, serum albumin, serum total protein, serum iron, iron binding capacity, serum zinc and copper, and serum vitamin C were studied weekly for 4 weeks and biweekly for 8 weeks.Main Outcome Measures: Presence/absence and stage of pressure sores.Main Results: Stage I pressure sores developed in 70 (35%) and Stage 2 or worse in 77 (38.5%) residents. Subjects who developed pressure sores were older (P < 0.001) and had lower systolic and diastolic blood pressure (P < 0.001) and higher body temperature (P < 0.001) than those without pressure sores. Dietary intake of all nutrients was lower among subjects who developed pressure sores. Using logistic regression, the best predictors or pressure sore development were the Braden Scale score, diastolic blood pressure, temperature, dietary protein intake, and age.Conclusions: Risk assessment is recommended upon admission to a nursing home and weekly for the first month. Risk status can be effectively predicted by using the Braden Scale in combination with knowledge of age, blood pressure, temperature, and dietary protein intake.