Pressure ulcers among elderly patients early in the hospital stay
Pressure ulcers among elderly patients early in the hospital stay
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DOI：
10.1093/gerona/61.7.749
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发表时间：
2006-07-01
影响因子：
5.1
通讯作者：
Ruffin, Althea
中科院分区：
文献类型：
--
作者：
Baumgarten, Mona;Margolis, David J.;Ruffin, Althea
背景资料。老年住院患者中的压疮降低了生活质量，增加了医院护理成本。有证据表明，仅仅几个小时不动就会出现压疮。这项研究的目标是估计住院前2天医院获得性压疮的发生率，并确定与较高发生率相关的患者特征。1998至2001年间进行了一项前瞻性队列研究。在住院的第三天，共有3233名65岁或以上的患者通过急诊科住进了两家研究医院的住院医疗服务，由一名研究护士进行了检查。使用标准标准确定压疮，并将其分类为预先存在的、可能是医院获得的或肯定是医院获得的。有201名患者有一个或多个可能或确定的医院获得性压疮，累积发生率为6.2%(95%可信区间，5.4%-7.1%)。压疮多为2期，且多位于骶部或后跟。多因素分析显示，年龄增加、男性、皮肤干燥、大小便失禁、翻床困难、入院前入住疗养院、最近住院、营养不良与压疮发生率显著相关。一小部分但相当大比例的老年急诊住院患者在入院后不久就会患上压疮。可能需要新的护理模式，以确保在老年人住院期间很早就提供预防性干预。
Background. Pressure ulcers among elderly hospital patients diminish quality of life and increase the cost of hospital care. Evidence suggests that pressure ulcers can arise after only a few hours of immobility. The goals of this study were to estimate the incidence of hospital-acquired pressure ulcers in the first 2 days of the hospital stay and to identify patient characteristics associated with higher incidence.Methods. A prospective cohort study was performed between 1998 and 2001. A total of 3233 patients 65 years old or older admitted through the Emergency Department to the inpatient Medical Service at two study hospitals were examined by a research nurse on the third day of hospitalization. Pressure ulcers were ascertained using standard criteria and were classified as either preexisting, possibly hospital-acquired, or definitely hospital-acquired.Results. There were 201 patients with one or more possibly or definitely hospital-acquired pressure ulcers for a cumulative incidence of 6.2% (95% confidence interval, 5.4%-7.1%). Most of the pressure ulcers were stage 2, and the majority were in the sacral area or on the heels. In multivariable analysis, pressure ulcer incidence was significantly associated with increasing age, male gender, dry skin, urinary and fecal incontinence, difficulty turning in bed, nursing home residence prior to admission, recent hospitalization, and poor nutritional status.Conclusions. A small but significant proportion of elderly emergently admitted hospital patients acquire pressure ulcers soon after their admission. New models of care may be required to ensure that preventive interventions are provided very early in the elderly person's hospital stay.