Epidemiology and Therapeutics Aspects of Pressure Ulcers in Two Sub-Sahara African University Teaching Hospitals

doi:10.20431/2455-572x.0402001

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…The result was comparable to research findings from Rwanda [19], Poland [14], Spain [12], and the review [3]. On the contrary, outcome was lower than previous studies conducted in Cameroon [18], Lebanon [15], Saudi Arabia [17], Brazil [11,13], Italy [39], and Canada [6]. The difference could be due to the smaller size of the studies in Brazil, Saudi Arabia, Lebanon, and Italy, which may overestimate the incidence.…”

Section: Discussionsupporting

confidence: 79%

“…However, Asian intensive care units reported a higher cumulative incidence, ranging from 31.4% to 39.3% [ 15 – 17 ]. On the other hand, the lower cumulative incidence reported from African intensive care units ranges from 15% to 26.8% [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Patients in intensive care units are more disadvantaged and vulnerable to the skin integrity disruption than non-ICU patients [6,9,11,20,21]. Several studies found that the incidence of pressure ulcers in intensive care patients was significantly higher than in non-ICU settings [6,9,13,15,18,[20][21][22][23][24]. According to a 2018 systematic review and meta-analysis in adult intensive care patients, the incidence of a pressure ulcer in adult ICU and non-ICU patients was 16.9%-23.8% and 12%-18%, respectively [3].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Predictors of Pressure Ulcers among Adult Patients in Intensive Care Units at Arba Minch and Jinka Hospitals, Southern Ethiopia

Digesa

Baru

Shanko

et al. 2023

BioMed Research International

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Introduction. The incidence of a pressure ulcer in intensive care units (ICU) is significantly higher than in noncritical care settings. The patients in the ICU are the most vulnerable group to disruption of the skin’s integrity. Prior studies in Ethiopia failed to evaluate pressure ulcers in intensive care units and were limited to general wards. The purpose of this study was to identify the incidence and predictors of pressure ulcers in adult patients admitted to intensive care units in Southern Ethiopia. Methods. A single-arm prospective open cohort of 216 patients was used to determine the presence of a pressure ulcer in the intensive care units from June 2021 to April 2022. A consecutive sampling was used until the sample size was reached. The data were collected using a structured questionnaire and analyzed using Stata 14. A cumulative incidence of a pressure ulcer was computed. The life table was used to estimate the cumulative survival. A multivariable Cox proportional hazard regression was used to identify independent predictors of a pressure ulcer. An adjusted hazard ratio with a 95% CI was used to measure the degree of association; a P value ≤ 0.05 was considered significant. Results. Twenty-five patients developed a pressure ulcer (PU), making a cumulative incidence of 11.57%. Out of 25 incident cases of pressure ulcers, four-fifths (80%) of the study patients developed PU within 6 days of their admission to the ICUs. The incidence rate was 32.98 PU per 1000 person-days of ICU stay. Pressure ulcers were most commonly found on the sacrum, followed by the shoulder. Among the incident cases, 52% were stage 2 ulcers. The presence of friction or shearing forces, as well as being 40 years of age or older, was independently associated with pressure ulcers. Conclusion. The overall cumulative incidence of the pressure ulcer was lower than that in other studies but occurred at a faster rate. Age (40 years of age or older) and the presence of friction or shearing forces were the main predictors of pressure ulcers in the intensive care units. Therefore, nurses working in ICUs should continually anticipate the risk of a pressure ulcer. Moreover, special attention should be given to patients of advanced ages. Furthermore, monitoring the installation of a mattress, keeping bed linens unwrinkled, and keeping patients in a proper position on a bed to prevent or reduce friction or shearing forces are very crucial in the prevention of pressure ulcers.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and Predictors of Pressure Ulcers among Adult Patients in Intensive Care Units at Arba Minch and Jinka Hospitals, Southern Ethiopia

Digesa

Baru

Shanko

et al. 2023

BioMed Research International

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Predictors of stroke favorable functional outcome in Guinea, results from the Conakry stroke registry

Cisse

Ligot

Condé

et al. 2022

Sci Rep

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Low- to middle-income countries (LMICs) now bear most of the stroke burden. In LMICs, stroke epidemiology and health care systems are different from HICs. Therefore, a high-income country (HIC)-based predictive model may not correspond to the LMIC stroke context. Identify the impact of modifiable variables in acute stroke management in Conakry, Guinea as potential predictors of favorable stroke outcome. Data were extracted from the Conakry stroke registry that includes 1018 patients. A logistic regression model was built to predict favorable stroke outcomes, defined as mRS 0–2. Age, admission NIHSS score, mean arterial blood pressure and capillary glycemia were chosen as covariates. Delay to brain CT imaging under 24 h from symptom onset, fever, presence of sores and abnormal lung auscultation were included as factors. NIHSS score on admission, age and ischemic stroke were included in the null model as nuisance parameters to determine the contribution of modifiable variables to predict stroke favorable outcome. Lower admission NIHSS, brain CT imaging within 24 h of symptoms onset and lower mean arterial blood pressure emerged as a significant positive predictors of favorable stroke outcome with respective odd ratios (OR) of 1.35 [1.28–1.43], 2.1 [1.16–3.8] and 1.01 [1.01–1.04]. The presence of fever or sores impacted negatively stroke favorable outcomes with OR of 0.3 [0.1–0.85] and 0.25 [0.14–0.45]. The area under receiver operating characteristic curves (AUC) of the model was 0.86. This model explained 44.5% of the variability of the favorable stroke outcome with 10.2% of the variability explained by the modifiable variables when admission NIHSS, and ischemic stroke were included in the null model as nuisance parameter. In the Conakry stroke registry, using a logistic regression to predict stroke favorable outcome, five variables that led to an AUC of 0.86: admission NIHSS, early brain CT imaging, fever, sores and mean blood pressure. This paves the way for future public health interventions to test whether modulating amendable variables leads to increased favorable stroke outcomes in LMICs.

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Epidemiology and Therapeutics Aspects of Pressure Ulcers in Two Sub-Sahara African University Teaching Hospitals

Cited by 2 publications

References 5 publications

Incidence and Predictors of Pressure Ulcers among Adult Patients in Intensive Care Units at Arba Minch and Jinka Hospitals, Southern Ethiopia

Incidence and Predictors of Pressure Ulcers among Adult Patients in Intensive Care Units at Arba Minch and Jinka Hospitals, Southern Ethiopia

Predictors of stroke favorable functional outcome in Guinea, results from the Conakry stroke registry

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