Factors Associated With Pressure Ulcers in Patients in a Surgical Intensive Care Unit
Factors Associated With Pressure Ulcers in Patients in a Surgical Intensive Care Unit
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DOI：
10.1097/won.0b013e3181f90a34
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发表时间：
2010-11-01
影响因子：
2.6
通讯作者：
Funk, Marjorie
中科院分区：
文献类型：
--
作者：
Slowikowski, Gerri C.;Funk, Marjorie
目的：我们试图描述外科重症监护病房(ICU)管理的患者发生压疮的情况，并报告开发一种适用于这一人群的压疮风险评估工具的初步工作，该工具结合了以前的工具中没有涉及的合并症和其他因素。研究对象和环境：369名在耶鲁-纽黑文医院外科ICU管理的患者为样本。方法：在这项前瞻性的两阶段研究中，收集了人口统计学和临床数据，包括Braden量表评分。首席调查员(G.C.S.)对所有患者进行皮肤评估。我们使用卡方分析和t检验来确定变量以包括在逐步Logistic回归分析中，以确定与压疮的发生独立相关的因素。目的：我们使用我们开发的表格收集数据，该表格包含在先前研究和临床实践中发现与压疮相关的人口统计学和临床因素。Braden量表得分从6分到21分，平均得分为11.9+/-2.2。较低的Braden量表评分、糖尿病的存在以及70岁或以上的患者独立预测压疮的发生。这些因素已被纳入初步外科ICU压疮风险评估量表。结论：本研究的结果表明，除了Braden量表评分较低外，70岁和糖尿病的诊断可能代表外科重症监护人群中与临床相关的压疮危险因素，具有这些因素的患者可能从更积极的预防性护理中受益。此外，外科ICU压疮风险评估量表在被推荐用于研究或实践环境之前，需要额外的心理测量测试。
PURPOSE: We sought to describe the occurrence of pressure ulcers in patients managed in a surgical intensive care unit (ICU) and report preliminary work toward development of a pressure ulcer risk assessment tool for use in this population that incorporates comorbidities and other factors not addressed in previous instruments.SUBJECTS AND SETTINGS: Three hundred sixty-nine patients managed in the surgical ICU at Yale-New Haven Hospital comprised the sample.METHODS: Demographic and clinical data, including Braden Scale scores, were collected in this prospective, 2-phase study. The principal investigator (G.C.S.) performed skin assessments on all patients. We used chi-square analysis and t tests to determine variables to include in a stepwise logistic regression analysis to determine factors independently associated with the development of pressure ulcers.INSTRUMENT: We collected data, using a form we developed that contained demographic and clinical factors found in previous research and in our clinical practice to be associated with pressure ulcers.RESULTS: Eighty-eight out of 369 patients (23.9%) experienced a hospital-acquired pressure ulcer. Braden Scale scores ranged from 6 to 21, with a mean score of 11.9 +/- 2.2. A lower Braden Scale score, the presence of diabetes mellitus, and patient age 70 years or older independently predicted the development of a pressure ulcer. These factors have been incorporated into the preliminary Surgical ICU Pressure Ulcer Risk Assessment scale.CONCLUSIONS: Findings from this study suggest that, in addition to a low Braden Scale score, age > 70 years and a diagnosis of diabetes may represent clinically relevant pressure ulcer risk factors in the surgical intensive care population and that patients with these factors may benefit from more aggressive preventive care. In addition, the Surgical ICU Pressure Ulcer Risk Assessment scale requires additional psychometric testing before its use can be recommended for the research or practice settings.