Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

Abstract

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

Perioperative risk factors of pressure injuries in Korean patients after surgery for intracranial hemorrhage: A retrospective cohort study

“…A GCS score of 8 or less denotes a severe head injury 24 . Previous studies have shown that a GCS score of 8 or less had a signi cant impact on length of ICU stay 15,31 . However, our nding showed that there was no signi cance between the low score of GCS and pressure injuries in the multivariable analysis.…”

“…pressure injuries compared to ischemic strokes 14,15 . Until now, in most emergency cases, surgical hematoma evacuation or craniectomy is primarily recommended in patients with intracranial hemorrhage because it can immediately reduce brain damage and control intracranial pressure 12 .…”

Aetiology, risk factors and treatment of typical and atypical pressure ulcers in patients with traumatic brain injury: A narrative review

“…An inadequate nutritional status accompanied by hypermetabolism leads to a remarkable reduction of subcutaneous adipose tissue and muscle degeneration. As a result, the development of PU and a decrease in the healing process would be attributed 20 . Further studies are required to evaluate the association between enteral feeding and the risk of PU development, so the optimal nutrition requirements for endorsing the process of wound healing remain uncertain.…”

“…The implementation of mechanical ventilation is associated with a significantly increased risk of PU development observed in affected patients 20 . Patients who are undergoing mechanical ventilation necessitate steady upward positioning of the head.…”

“…As a result, the development of PU and a decrease in the healing process would be attributed. 20 Further studies are required to evaluate the association between enteral feeding and the risk of PU development, so the optimal nutrition requirements for endorsing the process of wound healing remain uncertain. However, there is empirical evidence demonstrating increased demands for the consumption of energy, protein, zinc and essential vitamins, such as A, C, E and K. 21 According to scientific research, the utilization of oral nutritional supplements that are high in protein has shown to be efficacious in decreasing the manifestation of PUs by 25% in individuals who are predisposed to this medical condition.…”