Pressure Ulcer Risk Factors in Persons with Mobility-Related Disabilities
Pressure Ulcer Risk Factors in Persons with Mobility-Related Disabilities
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DOI：
10.1097/01.asw.0000653152.36482.7d
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发表时间：
2020-03-01
影响因子：
2.4
通讯作者：
Sonenblum, Sharon
中科院分区：
文献类型：
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作者：
Sprigle, Stephen;McNair, Douglas;Sonenblum, Sharon
ACTERIVETo评估压力性溃疡（PU）的风险与行动不便的人使用一个大的数据集，以确定人口统计学，实验室，血流动力学，和药理学的风险factors. METHODS队列的利益是残疾人谁有行动不便，并诊断为PU的风险。为了定义该队列，使用了符合皮肤保护轮椅垫的患者的诊断。数据来自Cerner Health Facts数据仓库。定义了两个队列：有和没有PU病史的人。分析包括描述性统计和多变量logistic回归模型。保留在模型中的变量使用LASSO、梯度增强和贝叶斯模型平均来识别。主要结果：所得到的队列包括超过87，000名有PU病史的人和超过110万名没有PU的人。数据显示，7个残疾组的PU患病率最高：阿尔茨海默病，脑瘫，偏瘫，多发性硬化症，截瘫/四肢瘫痪，帕金森病和脊柱裂。盆腔溃疡占PU的82%。男性或黑人残疾人的PU患病率更高。生理风险因素包括肾脏或肾脏疾病的存在，血清白蛋白降低，血清C-反应蛋白增加。CONCLUSIONSThe结果表明，虽然残疾人可以表现出广泛的功能范围，他们仍然在PU的风险，并应进行评估，适当的预防措施，包括支持表面和轮椅垫。
OBJECTIVETo assess pressure ulcer (PU) risk in persons with mobility impairments using a large data set to identify demographic, laboratory, hemodynamic, and pharmacologic risk factors.METHODSThe cohort of interest was persons with disabilities who have mobility impairments and are diagnostically at risk of PUs. To define this cohort, diagnoses that qualify patients for skin protection wheelchair cushions were used. Data were obtained from the Cerner Health Facts data warehouse. Two cohorts were defined: persons with and without a history of PUs. Analysis included descriptive statistics and multivariate logistic regression modeling. Variables retained in the model were identified using LASSO, gradient boosting, and Bayesian model averaging.MAIN RESULTSThe resulting cohorts included more than 87,000 persons with a history of PUs and more than 1.1 million persons who did not have a PU. The data revealed seven disability groups with the greatest prevalence of PUs: those with Alzheimer disease, cerebral palsy, hemiplegia, multiple sclerosis, paraplegia/quadriplegia, Parkinson disease, and spina bifida. Ulcers in the pelvic region accounted for 82% of PUs. Persons with disabilities who were male or black had a greater prevalence of PUs. Physiologic risk factors included the presence of kidney or renal disease, decreased serum albumin, and increased serum C-reactive protein.CONCLUSIONSThe results indicate that, although persons with disabilities can exhibit a wide functional range, they remain at risk of PUs and should be evaluated for proper preventive measures, including support surfaces and wheelchair cushions.