Pressure Ulcers: Developing Clinical Indicators in Evidence-based Practice. A Prospective Study

Abstract

Aims and objectives:It is widely recognized that Intensive Care Unit (ICU) patients have a greater likelihood of developing pressure ulcers in comparison to hospital or home care patients. Accordingly, this study aimed to evaluate whether specific clinical characteristics could be used as clinical indicators towards pressure ulcers prevention.Method:We monitored 210 hospitalized ICU patients during a 12-month period. Pressure ulcers were assessed following the current guidelines. Clinical characteristics such as gender, age, hospitalized days, hemodialysis treatment, hematocrit, and serum albumin levels were considered as the most common predictors for pressure ulcers development. The significance of associations was controlled using multiple logistic regression after adjusting for clinical characteristics and was presented as adjusted odds ratio (AOR).Results:The prevalence of pressure ulcers was 24.3%. Logistic regression revealed that patients with increased age AOR=1.04; (CI: 1.01-1.07) and last-long hospitalization AOR=1.17; (CI: 1.11-1.23) were significantly more likely to present pressure ulcers compared to the younger ones and patients with less length of stay, respectively. We also found that patients under hemodialysis treatment were more likely to present pressure ulcers AOR=4.09; (CI: 1.12-14.98) compared to patients that did not underwent hemodialysis and the risk of pressure ulcers development was decreased by 9% for every single unit of hematocrit value increase AOR=0.91; (CI: 0.82-0.99).Conclusion:Our data analysis confirms that the clinical characteristics that were studied are independently associated with pressure ulcers development, and therefore, it is a crucial incentive to consider that these specific clinical characteristics are important indicators in the evidence-based practice.

The prevalence, incidence, and associated factors of pressure injuries among immobile inpatients: A multicentre, cross‐sectional, exploratory descriptive study in China

“…This study has shown that the risk of PIs was higher for people aged over 65 years than for those aged 18 to 65 years. This result was consistent with the majority of published findings, which have shown a higher risk of PI at older age . However, Wielen et al and Magny et al found no significant association between age and the occurrence of PIs.…”

“…However, some prospective cohort studies that focused on immobile patients with hip fractures or spinal cord injuries in ICU settings found no significant differences between female and male immobile patients. 14,15,31,37,41 We found that PI prevalence is much higher for patients remaining immobile for 10 or more days, which suggests that more rigorous monitoring and management is needed to prevent PIs when patients remain in bed for 10 or more days or are expected to be immobile for a long time. This result is consistent with current literature which found that the length of immobility is an important predictor for PIs in immobile patients in ICUs and general wards.…”

“…Okuwa et al and Campanili et al also found that male immobile patients were at higher risk, compared with female immobile patients. However, some prospective cohort studies that focused on immobile patients with hip fractures or spinal cord injuries in ICU settings found no significant differences between female and male immobile patients …”

“…This result was consistent with the majority of published findings, which have shown a higher risk of PI at older age. 3,32,[37][38][39] However, Wielen et al 14 and Magny et al 31 found no significant association between age and the occurrence of PIs.…”

The Effect of Position Time on the Formation of Pressure Ulcer in Bedridden Patients

“…Özellikle, %24'ten az hematokrit değerleri ve 8,5 g/dL'nin altındaki hemoglobin değerleri, yetersiz doku oksijenlenmesine yol açarak, basınç ülseri riskini artırmaktadır. 18 Çalışmamızda, hemoglobin değerinin basınç yarası oluşumu üzerine etkisi incelendiğinde, hemoglobin ortalama değerinin 10,18±1,37 (min=7,50 maks=14,40) olduğu belirlenmiş ve hemoglobin değerinin basınç yarası oluşumu üzerinde etkili olduğu görülmüştür.…”