Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study.
Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study.
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DOI：
10.4037/ajcc2018293
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Cummins MR
中科院分区：
文献类型：
--
作者：
Alderden J;Zhao YL;Zhang Y;Thomas D;Butcher R;Zhang Y;Cummins MR
在重症监护患者中，约有一半的医院获得性压力损伤是第1阶段。虽然第1阶段的伤害是常见的，但与他们相关的结果在重症监护患者尚未进行检查。研究危重病患者中第1阶段压力损伤的结局，并确定与压力损伤恶化相关的因素。使用电子健康记录来确定I级创伤中心和学术医疗中心的哪些外科重症监护患者有1级压力损伤。竞争风险生存分析用于确定与压力损伤恶化相关的因素。对6377例患者记录的审查表明，259例患者（4.1%）发生了1期损伤。92名患者（35.5%）的损伤持续到出院，84名患者（32.4%）的损伤恶化为2期或以上，83名患者（32.0%）愈合。压力损伤恶化的患者更有可能是老年人（亚分布风险比[SHR]，1.02; 95% CI，1.01 - 1.03; P =.002），或血清乳酸水平较高（SHR，1.06; 95% CI，1.02 - 1.10; P =.007），血红蛋白水平较低（SHR，0.82; 95% CI，0.71 - 0.96; P =.01），或通过脉搏血氧仪测定的氧饱和度降低（<90%; SHR，1.50; 95% CI，1.00 - 2.25; P =.05）。约三分之一的患者（32.4%）的第1阶段压力损伤恶化。护士应考虑对年龄较大或氧气输送或灌注发生变化的患者进行最大限度的治疗。（American Journal of Critical Care）2018; 27：471 - 476）
Approximately half of hospital-acquired pressure injuries identified among critical care patients are stage 1. Although stage 1 injuries are common, outcomes associated with them among critical care patients have not been examined. To examine the outcomes of stage 1 pressure injuries among critical care patients and to identify factors associated with worsening of pressure injuries. Electronic health records were used to determine which surgical critical care patients at a level I trauma center and academic medical center had stage 1 pressure injuries. Competing risk survival analysis was used to identify factors associated with worsening of pressure injuries. Review of 6377 patient records indicated that 259 patients (4.1%) experienced stage 1 injuries. The injuries persisted until discharge from the hospital in 92 patients (35.5%), worsened into injuries of stage 2 or greater in 84 (32.4%), and healed in 83 (32.0%). Patients whose pressure injuries worsened were more likely to be older (subdistribution hazard ratio [SHR], 1.02; 95% CI, 1.01–1.03; P = .002), or to have higher levels of serum lactate (SHR, 1.06; 95% CI, 1.02–1.10; P = .007), lower levels of hemoglobin (SHR, 0.82; 95% CI, 0.71–0.96; P = .01), or decreased oxygen saturation by pulse oximetry(< 90%; SHR, 1.50; 95% CI, 1.00–2.25; P = .05). Stage 1 pressure injuries worsen in about one-third of patients (32.4%). Nurses should consider maximal treatment for patients who are older or who experience alterations in oxygen delivery or perfusion. (American Journal of Critical Care. 2018; 27:471–476)
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影响因子：
4.2
作者：
Nijs, Nele;Toppets, Adinda;Van Den Berghe, Greet
通讯作者：
Van Den Berghe, Greet
影响因子：
4.2
作者：
Isabel Gonzalez-Mendez, Maria;Lima-Serrano, Marta;Salvador Lima-Rodriguez, Joaquin
通讯作者：
Salvador Lima-Rodriguez, Joaquin
DOI：
10.4037/ajcc2013991
发表时间：
2013-11
期刊：
American journal of critical care : an official publication, American Association of Critical-Care Nurses
影响因子：
--
作者：
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通讯作者：
Lenz ER
影响因子：
3
作者：
Lima-Serrano, M.;Gonzalez-Mendez, M. I.;Lima-Rodriguez, J. S.
通讯作者：
Lima-Rodriguez, J. S.
影响因子：
3
作者：
Suriadi;Sanada, Hiromi;Subuh, Muhammad
通讯作者：
Subuh, Muhammad