Obesity and pressure ulcers among nursing home residents.
Obesity and pressure ulcers among nursing home residents.
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DOI：
10.1097/mlr.0b013e3182881cb0
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发表时间：
2013-06
期刊：
影响因子：
3
通讯作者：
Intrator O
中科院分区：
文献类型：
--
作者：
Cai S;Rahman M;Intrator O
研究疗养院（NH）人群中肥胖的患病率及其与压疮的关系，以及这种关系是否因护理助理（CNA）水平而异。1999-2009年全国最低数据集与认证和报告记录在线调查相关联。我们确定了新入院的NH居民谁成为长期居留者，并跟踪他们长达1年。结果变量为1年随访期间是否存在压疮。居民分为正常（18.5<=BMI<30 kg/m2）、轻度肥胖（30 <=BMI <35 kg/m2）和中度或重度肥胖（BMI>=35 kg/m2）。进行了汇总和分层分析，以检查肥胖和压疮之间的关系，以及它如何因设施CNA水平而变化。在过去十年中，新入院的NH居民的肥胖患病率从16.9%增加到25.8%。长期居住的居民中，肥胖与压疮的高风险相关。在考虑了基线时的个人健康状况和设施水平的变化后，肥胖和压疮之间的关系仍然存在。此外，设施内肥胖和压疮之间的关系因设施CNA水平而异。在低CNA水平的NHS中，中度或重度肥胖居民的压疮几率比非肥胖居民高18.9%。中、高CNA水平设施的阳性率分别为14.0%和12.8%。为了应对NHS中日益增长的肥胖流行病，政策应侧重于改善为肥胖居民提供的护理的策略。
To examine the prevalence of obesity and its relationship with pressure ulcers among nursing home (NH) populations, and whether such relationship varies with certified nursing assistant (CNA) level in NHs. The 1999–2009 nationwide Minimum Data Sets were linked with Online Survey of Certification and Reporting records. We identified newly admitted NH residents who became long-stayers and followed them up to 1 year. The outcome variable was presence of pressure ulcers during the 1-year follow-up period. Residents were categorized as normal (18.5<=BMI<30 kg/m2), mild obesity (30 <=BMI <35 kg/m2) and moderate or severe obesity (BMI>=35 kg/m2). Pooled and stratified analyses were performed to examine the relationship between obesity and pressure ulcers, and how it varied by facility CNA level. The prevalence of obesity increased from 16.9% to 25.8% among newly admitted NH residents over the last decade. Obesity was associated with higher risks of pressure ulcers among long-stay residents. The relationship between obesity and pressure ulcers persisted after accounting for individual health conditions at the baseline and facility-level variations. Further, the within-facility relationship between obesity and pressure ulcers varied by facility CNA levels. The odds of pressure ulcers were 18.9% higher for residents with moderate or severe obesity than for non-obese residents within NHs with low CNA levels. The percents for medium and high CNA level facilities were 14.0% and 12.8%, respectively. To prepare for the growing obesity epidemic in NHs, policies should focus on strategies to improve care provided for obese residents.