Pressure sores in intensive care: defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools.
Pressure sores in intensive care: defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools.
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DOI：
10.1016/s1036-7314(01)80019-9
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发表时间：
2001-02-01
期刊：
影响因子：
--
通讯作者：
Green, M
中科院分区：
文献类型：
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作者：
Boyle, M;Green, M
重症监护病房 (ICU) 的患者发生压疮的风险很高，人们提倡使用压疮风险工具作为识别高危患者的一种方法。进行了一项前瞻性多中心观察研究，以确定压疮的发生率，评估两种压疮风险量表，并确定与重症监护相关的风险因素。对患者 (n = 534) 进行了压疮评估。每天分别为其中 314 名和 188 名患者完成 Waterlow 和 Jackson/Cubbin 风险量表。总共记录了 75 个压疮。其中，34 人入院时在场。其余 41 例中，16 例为 1 级，24 例为 2 级。压疮 (PS) 发生率为 5.2%。以 PS/1000 个患者日表示，每 1000 个患者日有 18.48 个压疮。使用接受者操作特征（ROC）分析来测试风险评分预测压疮的能力。使用生存函数（Kaplan Meier）分析风险评分与压疮的关联，并使用对数检验（Mantel-Cox）比较变量。使用生存回归模型开发并测试了与压疮发生相关的因素。两种风险量表都不能很好地预测压疮（两者的 ROC 曲线面积约为 70%）。昏迷/反应迟钝/瘫痪和镇静以及心血管不稳定等因素与压疮显着相关，相对风险分别为 4.2 和 2.5。风险随着时间的推移而增加，20 天时累积风险达到 50%。
Patients in intensive care units (ICU) are at high risk of developing pressure sores and the use of pressure sore risk tools has been advocated as a means of identifying patients at risk. A prospective multi-site observational study was conducted to define the incidence of pressure sores, assess two pressure sore risk scales and to define risk factors relevant to intensive care. Patients (n = 534) were assessed for the presence of pressure sores. The Waterlow and Jackson/Cubbin risk scales were completed each day for 314 and 188 of these patients respectively. A total of 75 pressure sores were recorded. Of these, 34 were present on admission. Of the remaining 41, 16 were classified as Grade 1 and 24 as Grade 2 sores. The pressure sore (PS) incidence was 5.2 per cent. Expressed as PS/1000 patient days there were 18.48 pressure sores per 1000 patient days. The ability of the risk scores to predict pressure sores was tested using a Receiver Operating Characteristic (ROC) analysis. The association of risk score with pressure sores was analysed using a survival function (Kaplan Meier) and variables compared using a logrank test (Mantel-Cox). Factors associated with pressure sore occurrence were developed and tested using a survival regression model. Both risk scales were poor predictors of pressure sores (ROC curve area approximately 70 per cent for both). The factors, coma/unresponsiveness/paralysed & sedated and cardiovascular instability were significantly associated with pressure sores with relative risks of 4.2 and 2.5 respectively. Risk increased as a function of time such that the cumulative risk was 50 per cent at 20 days.