Incidência de úlceras por pressão em pacientes de Unidade de Terapia Intensiva Cardiopneumológica

Abstract

RESUMO Objetivo Identificar e analisar os coeficientes de incidência de úlceras por pressão (UP) e os fatores de risco para o seu desenvolvimento em pacientes críticos com doenças cardiopneumológicas. Método Estudo de coorte, prospectivo realizado na Unidade de Terapia Intensiva (UTI) Cardiopneumológica de um hospital de grande porte na cidade de São Paulo, durante os meses de novembro de 2013 a fevereiro de 2014. Participaram do estudo 370 pacientes maiores de 18 anos, que não apresentavam UP na admissão e que estavam na UTI há menos de 24 horas. Os dados foram analisados por meio de análises univariadas e multivariada (Classification And Regression Tree - CART). Resultados Os coeficientes de incidência de UP foram: 11,0% para o total, distribuindo-se em 8,0% entre os homens e 3,0% para as mulheres (p=0,018); 10,0% na raça branca e 6,5% em pessoas com idade igual e superior a 60 anos. Os principais fatores de risco encontrados foram tempo de permanência na UTI igual ou superior a 9,5 dias, idade igual ou superior a 42,5 anos e raça branca. Conclusão O estudo contribui para os conhecimentos relacionados à epidemiologia das UP em pacientes críticos com doenças cardiopneumológicas, favorecendo o planejamento de cuidados preventivos específicos para essa clientela.

Incidência de lesão por pressão em unidade de terapia intensiva para adultos

“…Despite the above, the incidence of this study was higher than that of the study 22 performed in the ICU in the countryside of São Paulo, which de ned the rate as 13.95%; and another study that found an incidence of 11.0% in the city of São Paulo in a cardiopneumological ICU 11 . In addition, the incidence found in this study was also higher than double the average result (10.1%) of the survey, also in São Paulo, with the participation of three teaching hospitals 9 .…”

“…However, it should be noted that the study cited did not include ICU in its sample, so it may not be considered a reliable standard of comparison, but it certainly can be interpreted as a north for improvement. Regarding the location of injuries in the sample (Table 4), he highest concentration (76.5%) of PI in the sacral region is an aspect of wide agreement in the literature 8,[10][11][12][13] . In addition to the fact that the second largest portion of PI involvement occurred in the scapular region of the patients, it can be inferred that the skin care of the back, although not exclusive, should be a factor of attention to the health team and, mainly of nursing of the ICU researched.…”

“…e total PI was 17 injuries. In this respect, Table 4 Another recent study identi ed that there is a statistically significant association between male gender and the development of PI in an ICU for patients with cardiac and respiratory diseases 11 . Regarding this, it is noticed that the clinical pro le of the sample of this research possibly returned to the surgical treatment, since the greater part of the bases for the medical diagnosis of hospitalization in the ICU was related to trauma and to neurological problems (Table 1).…”

“…Lesión por presión; Unidades de terapia intensiva; Seguridad del paciente; Cuidados de enfermería; Estomaterapia In spite of the evolution of the knowledge of risk factors and measures of PI prevention, its incidence -which is an indicator of quality assistance 9 , especially in ICU, has been a persistent problem, and it is still necessary to be used as a research object [10][11][12] . is is because the incidence of PI is based on the measurement of new cases of the adverse event, that is, it is an epidemiological measure that may favor the (re)planning of care actions with a focus on the rational prevention of new injuries, according to a scienti cally situational diagnosis supported 9 .…”

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

“…There are evidences that intrinsic and extrinsic factors predispose to PI development, so identifying risk factors during patient care is an asset to hospital institutions, which can plan specific intervention measures and put them into practice in order to prevent PI [9]. …”