Malnutrition, Tube Feeding and Pressure Sores: Data Are Incomplete

Finucane, Thomas E.

doi:10.1111/j.1532-5415.1995.tb05822.x

Cited by 89 publications

(30 citation statements)

References 24 publications

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“…Some studies have demonstrated an independent association between low serum albumin level and pressure ulcer development [9][10][11][12][13], while other similar studies have not [6,14,15]. Confusion or impaired mental status is frequently cited as being associated with pressure ulcers based on clinical judgment and is a component of the two clinical assessment scales recommended by the Agency for Health Care Policy and Research [16].…”

mentioning

confidence: 99%

Low Serum Albumin Levels, Confusion, and Fecal Incontinence: Are These Risk Factors for Pressure Ulcers in Mobility-Impaired Hospitalized Adults?

Reed

Hepburn

Adelson³

et al. 2003

Gerontology

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Background: Studies of risk factors for clinically significant pressure ulcers in the hospital have been limited by the small number of study subjects that develop pressure ulcers, resulting in contradictory findings regarding some risk factors. Objective: To determine if three risk factors (low serum albumin level, fecal incontinence, and confusion) were significant risk factors when tested in a large data set. Methods: The study design was a longitudinal cohort study using data collected as a component of a multi-site controlled clinical trial. The data were collected at 47 Veterans Affairs Hospitals. 2,771 subjects that required high levels of nursing care were identified to have mobility impairment. Their medical records were abstracted using a standard form to identify a large number of potential risk factors. The subsequent development of stage 2 or greater pressure ulcers was recorded for a maximum of 14 days after admission. Results: 406 patients (14.7%) subsequently developed at least one stage 2 or greater pressure ulcer over a 2-week period. In a multivariate model, the presence of low albumin levels (odds ratio OR = 1.40) and confusion (OR = 1.45) were both found to be statistically significant risk factors, while fecal incontinence was not. Having a Do Not Resuscitate (DNR) order was also a significant risk factor (OR = 1.55). Two other known risk factors also entered the model: being malnourished (OR = 1.69) and requiring a urinary catheter (OR = 1.55). Conclusions: This study confirmed confusion and low albumin as pressure ulcer risk factors, but not fecal incontinence. A DNR order was found to be a new pressure ulcer risk factor not previously described in the literature.

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confidence: 99%

Low Serum Albumin Levels, Confusion, and Fecal Incontinence: Are These Risk Factors for Pressure Ulcers in Mobility-Impaired Hospitalized Adults?

Reed

Hepburn

Adelson³

et al. 2003

Gerontology

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“…This assessment must include using pressure ulcer risk assessment tools that provide a useful aide memoir to identifying the 'at risk' individual but must be used in conjunction with professional judgement. There are a variety of tools that may be used but none are specifically designed for the patient undergoing surgery (Finucane, 1995;MacDonald, 1995) and do not specifically focus on the heel. Predicting potential pre operative complications is an important quality indicator (Lindholm et al, 2008).…”

Section: Assessing Riskmentioning

confidence: 99%

Heel ulceration – An exploration of the issues

Ousey

2009

Journal of Orthopaedic Nursing

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“…In our study, an albumin level less than 36 g/L was an independent predictor of HAPUs. According to a review 34 on the relationship between PUs and nutrition, 7 of 13 studies indicated a statistically significant association. A systematic review and meta-analysis 35 provided stronger evidence, indicating that albumin level was a significant predictor of PUs.…”

Section: Discussionmentioning

confidence: 99%

Predicting the Risk for Hospital-Acquired Pressure Ulcers in Critical Care Patients

Deng

2017

Critical Care Nurse

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Background Assessments of risk for pressure ulcers in critical care patients may not include important predictors. Objective To construct risk-prediction models of hospital-acquired pressure ulcers in intensive care patients and compare the models' predictive validities with validity of the Braden Scale. Methods Data were collected retrospectively on patients admitted to intensive care from October 2011 through October 2013. Logistic regression and decision trees were used to construct the risk-prediction models. Predictive validity was measured by using sensitivity, specificity, positive and negative predictive values, and area under the curve. Results With logistic regression analysis, 6 factors were significant independent predictors. With the decision tree, 4 types of high-risk populations were identified. Predictive validity of Braden Scale scores was lower than the validities of the logistic regression and the decision tree models. Conclusion Risk for hospital-acquired pressure ulcers is overpredicted with the Braden Scale, with low specificity and low positive predictive value. (Critical Care Nurse. 2017;37[4]:e1-e11)

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Malnutrition, Tube Feeding and Pressure Sores: Data Are Incomplete

Cited by 89 publications

References 24 publications

Low Serum Albumin Levels, Confusion, and Fecal Incontinence: Are These Risk Factors for Pressure Ulcers in Mobility-Impaired Hospitalized Adults?

Low Serum Albumin Levels, Confusion, and Fecal Incontinence: Are These Risk Factors for Pressure Ulcers in Mobility-Impaired Hospitalized Adults?

Heel ulceration – An exploration of the issues

Predicting the Risk for Hospital-Acquired Pressure Ulcers in Critical Care Patients

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