Identification of Pre-Operative and Intra-Operative Variables Predictive of Pressure Ulcer Development in Patients Undergoing Urologic Surgical Procedures

Connor, Thomas R.; Sledge, Jennifer; Bryant-Wiersema, Laurel; Stamm, Linda; Potter, Patricia

doi:10.7257/1053-816x.2010.30.5.289

Cited by 38 publications

(49 citation statements)

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“…Most of the studies agreed that pressure ulcers occurred commonly in older patients, but only Wright et al found decreasing age to be associated with HAPU; however, Wright's study had a much smaller sample size (N = 88), and hence, it may be under‐powered to detect statistical significance. There were also studies that did not find older age to be significantly associated with HAPU, but their study population's mean age was between 48 and 58 years. Interestingly, Kopp et al also did not find older age to be associated with HAPU even though their sample population was patients older than 70 years old who underwent surgery for hip fracture.…”

Section: Introductionmentioning

confidence: 93%

A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

Aloweni

Ang

Fook‐Chong

et al. 2018

International Wound Journal

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Surgical patients are prone to developing hospital‐acquired pressure ulcers (HAPU). Therefore, a better prediction tool is needed to predict risk using preoperative data. This study aimed to determine, from previously published HAPU risk factors, which factors are significant among our surgical population and to develop a prediction tool that identifies pressure ulcer risk before the operation. A literature review was first performed to elicit all the published HAPU risk factors before conducting a retrospective case‐control study using medical records. The known HAPU risks were compared between patients with HAPU and without HAPU who underwent operations during the same period (July 2015‐December 2016). A total of 80 HAPU cases and 189 controls were analysed. Multivariate logistic regression analyses identified eight significant risk factors: age ≥ 75 years, female gender, American Society of Anaesthesiologists ≥ 3, body mass index < 23, preoperative Braden score ≤ 14, anaemia, respiratory disease, and hypertension. The model had bootstrap‐corrected c‐statistic 0.78 indicating good discrimination. A cut‐off score of ≥6 is strongly predictive, with a positive predictive value of 73.2% (confidence interval [CI]: 59.7%‐84.2%) and a negative predictive value of 80.7% (CI: 74.3%‐86.1%). SPURS contributes to the preoperative identification of pressure ulcer risk that could help nurses implement preventive measures earlier.

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Section: Introductionmentioning

confidence: 93%

A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

Aloweni

Ang

Fook‐Chong

et al. 2018

International Wound Journal

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“…Seven articles 19 -21,22,24,28,30 did not specify the duration of follow-up. Only six studies 20,21,26,27,29,32 reported on how the patient was positioned during surgery.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

“…Connor et al 32 Gao et al 20 Kim a Haemoglobin and b duration of surgery. An inverse-variance random-effects model was used for meta-analysis.…”

Section: Weight (%) Mean Difference Mean Differencementioning

confidence: 99%

Postoperative pressure injuries in adults having surgery under general anaesthesia: systematic review of perioperative risk factors

Haisley

Sørensen

Sollie

2020

British Journal of Surgery

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Background Pressure injuries (PIs) after surgery affect thousands of people worldwide. Their management is expensive, a cost that can be reduced with proper preventive measures. Patients having surgery under general anaesthesia are at risk of developing PI, yet no specific tool has been developed to assess the risk in these patients. This review aimed to summarize the published data on perioperative risk factors associated with the development of PI in adults having surgery under general anaesthesia. Methods All studies reporting on risk factors associated with the development of PI were included. Data were extracted from all articles and meta‐analysis was performed when three or more studies reported on a specific variable. Results The analysis identified five factors significantly associated with the development of PIs: cardiovascular disease, respiratory disease, diabetes mellitus, low haemoglobin level and longer duration of surgery. Factors not associated included serum albumin concentration, use of vasopressors during surgery, use of corticosteroids, sex and age. Conclusion Cardiovascular disease, respiratory disease, diabetes mellitus, anaemia and duration of surgery should be taken into consideration when trying to identify surgical patients at high risk of developing PIs. These factors could be used to predict PIs after surgery.

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“…Average scores for the outcome Tissue Integrity: Skin & Mucous Membranes also differed between the first and second evaluations (0.66) and between the second and fifth evaluations (0.41). This denotes that the integrity of skin and mucous membranes was compromised immediately after the surgical intervention, perhaps as a result of surgical positioning, while the improvement in average scores over the postoperative demonstrates that this injury regressed because, once there was no more pressure on areas associated with surgical positioning, the normal pattern of skin perfusion was reestablished (Carneiro & Leite, ; Connor et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…These outcomes and indicators provide nurses with objective evidence of patients' care needs in the intraoperative period and are essential to immediate and late postoperative recovery. Hypothermia, for instance, is an event that persists in the postoperative period, can trigger cardiac complications and peripheral vasoconstriction and is directly related to development of pressure sores (Akhavan et al, ; Connor et al, ). Thus, evaluation of the Thermoregulation outcome is related to the Circulation Status outcomes Tissue Perfusion: Cellular and Tissue Perfusion: Peripheral, and, consequently, to the implementation of preventive interventions.…”

Section: Discussionmentioning

confidence: 99%

Clinical indicators of nursing outcomes classification for patient with risk for perioperative positioning injury: A cohort study

Bjorklund-Lima

Müller‐Staub

Cardozo

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To test the validity and reliability of Nursing Outcomes Classification outcomes and their clinical indicators for patients with the nursing diagnosis ‘Risk for perioperative positioning injury’. Background Surgical positioning is an essential part of perioperative nursing practice. The use of a standardised language values the clinical evaluation of the perioperative nurse, reinforcing its contribution to surgical patient care. Design Longitudinal concept validation cohort study. Methods Patients were selected based on the operating room surgical schedule. The sample included adult patients who underwent elective surgical procedures requiring anaesthesia, classified as surgical class 2, 3 or 4. Outcomes were measured with an instrument, which included 33 clinical indicators for eight outcomes. The patients were assessed at five distinct time points in the perioperative phases. This study followed the STROBE guidelines. Results A total of 50 patients were included. Each underwent five clinical assessments, for a total of 250 documented assessments. Differences in evaluations were mostly related to reduced scores of clinical indicators in the immediate postsurgical time points, which recovered to the highest score at the end of the fifth (and last) evaluation. The results of factor analysis and Cronbach's alpha calculations suggested a new configuration for this nursing outcomes, consisting of five outcomes—Circulation Status, Tissue Perfusion: peripheral, Neurological Status: peripheral, Tissue Integrity: skin and mucous membranes and Thermoregulation—and 13 clinical indicators. Conclusions Nursing Outcomes Classification outcomes and clinical indicators for the nursing diagnosis at ‘Risk for perioperative positioning injury’ are sensitive to patient states during the perioperative period. Relevance to clinical practice Use of nursing taxonomies during the perioperative period may contribute to the discussion on the role of perioperative nurses and their relevance in patient care.

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Identification of Pre-Operative and Intra-Operative Variables Predictive of Pressure Ulcer Development in Patients Undergoing Urologic Surgical Procedures

Cited by 38 publications

References 0 publications

A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

Postoperative pressure injuries in adults having surgery under general anaesthesia: systematic review of perioperative risk factors

Clinical indicators of nursing outcomes classification for patient with risk for perioperative positioning injury: A cohort study

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