APACHE II Death Risk and Length of Stay in the ICU Are Associated With Pressure Injury in Critically Ill Patients

Abstract

BackgroundThe aim of this study was to identify factors associated with pressure injury (PI) occurrence in critically ill patients. This was a retrospective cohort study conducted at a mixed intensive care unit (ICU).MethodsUnivariate analysis and logistic regression were used to identify which variables are associated with PI.ResultsTwenty-one (15%) of 142 patients developed PI. The median and the range of the variables in the groups without and with PI were as follows: Braden scale risk score, 13 (8 - 20) and 10 (8 - 14) points, respectively; Acute Physiology and Chronic Health Evaluation II (APACHE II) death risk, 39% (2 - 97%) and 75% (26 - 96%), respectively; and length of stay in the ICU, 4 (2 - 36) and 16 (5 - 29) days, respectively. The socio-demographic variables included in the logistic regression were age (P = 0.09), Braden scale risk score (P = 0.0003), APACHE II death risk (P < 0.0001), length of stay in the ICU (P < 0.0001) and reason for ICU admission (P = 0.09). Only APACHE II death risk and length of stay in the ICU presented significant differences; the odds ratios were 1.05 and 1.25, respectively, and the 95% confidence intervals were 1.01 - 1.09 and 1.12 - 1.39, respectively.ConclusionAPACHE II death risk and length of stay in the ICU are probably associated with PI occurrence in the study population.

Skin Failure Among Critically Ill Patients Afflicted with Coronavirus Disease 2019 (COVID-19)

“…40 Identification and mitigation of risk becomes paramount. Older age, premorbid conditions, high illness severity, 12 derangements of organ function, 14 invasive interventions, and the attendant immobility characteristic of treating critical illness (e.g., prone positioning, CRRT 22 ) may amplify the risk of SF. 4,9,18,41,42 BMI at either extreme (19 > BMI < 40) has been associated with high risk of SF related to bony prominences.…”

“…Multifactorial historic risk factors include patients’ premorbid state of health, physiologic stressors, organ dysfunction, 4,9,10 and increased survivability of catastrophic illness through advances in the delivery of life-sustaining care. 11 Critically ill patient characteristics implicated in the development of SF include high severity of illness, 12 immobility, 13 organ dysfunction, 14 and receipt of any of numerous organ-support modalities, including mechanical ventilation- often with neuromuscular blockade, 4,15 vasopressor therapy, 16,17 or renal replacement therapy (RRT). 18…”

Risk Factor Analysis and Risk Prediction Model Construction of Pressure Injury in Critically Ill Patients with Cancer: A Retrospective Cohort Study in China

“…A higher score means a higher risk of death [ 23 ]. Previous studies have shown that the APACHE II risk of death determination is associated with the incidence of PI in critically ill patients [ 24 ]. The present study found that the APACHE II score was an independent risk factor for the occurrence of PI in critically ill patients with cancer.…”

Relationship between a pressure redistributing foam mattress and pressure injuries: An observational prospective cohort study

“…Furthermore, we did not collect the data of the APACHE II score as a confounding variable for the relationship between the PRFM and the development of pressure injuries. However, the influence of the APACHE II score on the development of pressure injuries is inconsistent based on existing evidence [ 61 , 62 ]. We included the Braden score in the analysis, which is more widely and consistently used as a significant predictor of pressure injuries [ 34 ].…”