Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit
Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit
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DOI：
10.1111/jocn.14091
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发表时间：
2018-03-01
影响因子：
4.2
通讯作者：
Salvador Lima-Rodriguez, Joaquin
中科院分区：
文献类型：
--
作者：
Isabel Gonzalez-Mendez, Maria;Lima-Serrano, Marta;Salvador Lima-Rodriguez, Joaquin
目的和目标确定压疮的发病率，发病率和危险因素在危重病patients.Backgroundpressure溃疡代表在临床实践中最常见的健康问题之一。具体来说，危重病人谁是在重症监护病房住院有较高的风险发展压力性溃疡，与发病率波动之间的3.3-39.3%，根据以前的研究。DesignProspective cohort study. MethodsThirty和35个成年患者（18岁以上）谁是在重症监护病房住院至少24小时，监测了最多32天。如果他们在入院时有压疮，则被排除在外。使用Kaplan-Meier方法计算I-IV期压疮的生存率。多因素考克斯回归模型进行了调整，以确定压疮的主要危险因素：人口统计学，临床，预后和治疗variables.ResultsThe发病率的压疮在危重病人是8.1%，发病率为11.72压疮1,000天的重症监护病房停留; 40.6%的压疮为I期，59.4%为II期，主要发生在骶骨。根据考克斯模型，压疮的主要危险因素是院内并发症，预后评分系统（SAPS III）和长度immobilisation.ConclusionsThe压疮的发病率低于在最近的研究中所示。并发症的单位和预后评分与压疮的风险因素，但令人惊讶的是，固定的长度是一个保护factor.Relevance临床practiceSurvival分析的压疮允许识别的风险因素与此相关的健康问题在重症监护病房。确定这些因素可以帮助护士建立干预措施，以防止在这种医疗保健方案中的压疮，因为压疮预防是护理质量的指标。
Aims and objectivesTo determinate the incidence, incidence rate and risk factors of pressure ulcers in critical care patients.BackgroundPressure ulcers represent one of the most frequent health problems in clinical practice. Specifically, critical patients who are hospitalised in intensive care units have a higher risk of developing a pressure ulcer, with an incidence that fluctuates between 3.3-39.3% according to previous studies.DesignProspective cohort study.MethodsThree hundred and thirty-five adult patients (over 18 years old) who were hospitalised in intensive care units for at least 24hr were monitored for a maximum of 32days. They were excluded if they had a pressure ulcers at admission. The survival rate for pressure ulcers, from stages I-IV, was calculated using the Kaplan-Meier method. A multivariate Cox regression model was adjusted to identify the main risk factors for pressure ulcers: demographic, clinical, prognostic and therapeutic variables.ResultsThe incidence of pressure ulcers in critical patients was 8.1%, and the incidence rate was 11.72 pressure ulcers for 1,000days of intensive care units stay; 40.6% of pressure ulcers were of stage I and 59.4% of stage II, mainly in the sacrum. According to the Cox model, the main risk factors for pressure ulcers were in-hospital complications, prognostic scoring system (SAPS III) and length of immobilisation.ConclusionsThe incidence of pressure ulcers is lower than that shown in recent studies. Complications on the unit and the prognosis score were risk factors associated with pressure ulcers but, surprisingly, length of immobilisation was a protective factor.Relevance to clinical practiceSurvival analysis of pressure ulcer allows for identification of risk factors associated with this health problem in the intensive care units. Identifying these factors can help nurses establish interventions to prevent pressure ulcers in this healthcare scenario, given that pressure ulcers prevention is an indicator of nursing quality.