Use of High-Frequency Ultrasound to Detect Heel Pressure Injury in Elders
Use of High-Frequency Ultrasound to Detect Heel Pressure Injury in Elders
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DOI：
10.1097/won.0b013e3182652648
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发表时间：
2012-09-01
影响因子：
2.6
通讯作者：
Nichols, Lynn Wemett
中科院分区：
文献类型：
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作者：
Helvig, Elizabeth I.;Nichols, Lynn Wemett
目的：检查高频超声 (HFU) 在检测老年患者足跟压力损伤方面的有用性，比较可视化压疮的患病率与隐性损伤的患病率，并确定 HFU 是否有助于预测足跟压力损伤的发展。 受试者和背景：样本包括 100 名年龄在 65 岁或以上、布雷登量表评分为 10 至 17 分且仍在住院的患者28 天或更短。参与者至少有 1 个脚后跟没有明显的压力损伤。研究地点是美国东北部一家拥有 528 个床位的城市医院。 方法：该研究采用前瞻性、描述性、观察性设计来收集数据。在初次就诊时，通过图表审查和体检来获取有关压疮危险因素的数据，并通过目视和 HFU 评估脚后跟。随后的就诊包括对压力性损伤的目视和扫描评估。研究中的患者至少见过两次； 82 例进行了 3 次评估，43 例进行了 4 次评估。结果：在 520 名符合纳入标准的患者中，可见足跟压疮的患病率为 7.3%。略多于十分之一 (10.1%) 的无足跟溃疡受试者在进入研究时进行了 2 次足跟扫描，结果正常。年龄、布雷登量表评分、足部温度、水肿和肿胀度并不是足跟扫描异常的统计学显着预测因素。然而，低摩擦/剪切评分与异常脚后跟扫描之间存在统计学上的显着关系，特别是与右脚相关。结论：高频超声比视觉评估更能检测到隐匿性损伤，但由于老茧和其他皮肤变化，扫描在脚后跟上不容易解释。看来患者的右脚跟比左脚跟更容易受到压力损伤，并且可以通过低摩擦/剪切分数来预测风险。
PURPOSE: To examine the usefulness of high-frequency ultrasound (HFU) to detect heel pressure injury in geriatric medical patients, to compare the prevalence rates of visualized pressure ulcers with the prevalence of hidden injury, and to determine whether HFU could assist in predicting the development of heel pressure injury.SUBJECTS AND SETTING: The sample comprised 100 medical patients who were aged 65 years or older, had a Braden Scale score of 10 to 17, and remained hospitalized 28 days or less. Participants had at least 1 heel free of visible pressure injury. The study setting was a 528-bed urban hospital in the northeastern United States.METHODS: The study used a prospective, descriptive, observational design for data collection. At the initial visit, chart review and physical examination were used to obtain data about pressure ulcer risk factors, and heels were assessed visually and with HFU. Subsequent visits included visual and scan evaluations for pressure injury. Patients in the study were seen at least twice; 82 were assessed 3 times and 43 were assessed 4 times.RESULTS: The prevalence rate of visible heel pressure ulcers was 7.3% for 520 patients who met inclusion criteria. Slightly more than one-tenth (10.1%) of subjects without heel ulcers had 2 normal heels scans upon entry into the study. Age, Braden Scale score, foot temperature, edema, and turgor were not statistically significant predictors of abnormal heel scans. However, there was a statistically significant relationship between low friction/shear scores and abnormal heel scans, particularly in relation to the right foot.CONCLUSIONS: High-frequency ultrasound detected occult injury more than visual assessment, but scans are not easy to interpret in heels due to calluses and other skin changes. It appears that patients have a greater tendency for pressure injury on the right heel than on the left heel and risk may be predicted by low friction/shear scores.