Úlceras por presión en pacientes ingresados en Medicina Interna: factores asociados y mortalidad

Díez-Manglano, Jesús; Fernández-Jiménez, Carolina; Lambán-Aranda, M.P.; Landa-Santesteban, M.C.; Isasmendi-Pérez, S. Isasi de; Moreno-García, Pablo; Bejarano-Tello, E.; Barranco-Usón, J.; Munilla-López, E.; Corral-Beamonte, Esther Del

doi:10.1016/j.rce.2016.07.003

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…An association was also found in the days of hospital stay and the development of HAPU, with this association increasing exponentially as the days of hospitalization increase. This result is supported by other published studies that state that patients with PUs had longer average stays [45].…”

Section: Discussionsupporting

confidence: 87%

Incidence of hospital-acquired pressure ulcers in patients with "minimal risk" according to the "Norton-MI" scale

Díaz-Caro

Gómez-Heras

2020

PLoS ONE

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Introduction Pressure ulcers (PUs) nowadays are a major health problem in society, associated with increased morbidity and increased health care costs. The incidence of HAPU is an indicator of health care quality. Objective To describe the profile of patients with minimal risk on the Norton-MI scale who developed PUs during hospitalization, and to identify the incidence of hospital-acquired pressure ulcers (HAPU). Methods Retrospective cohort study conducted between 2014 and 2017. Study population Patients over 18 years of age classified as "minimum risk" according to Norton-MI, admitted to acute hospital units of the Severo Ochoa University Hospital-Madrid-Spain. Patients were classified as patients with hospital-acquired pressure ulcers (PWHAPU) if they developed one or more new PU during their hospitalization. Variables Sociodemographic variables, hospitalization units, Morton-MI score and characteristics of the risk factors of HAPU were studied. Results The risk of PU was evaluated in 5530 patients, being 1260 patients classified as "minimum risk", with a median of 16 points in the Norton-MI scale. The average age was 76 years old and 52.5% were women. Principal causes of admission: traumatological pathologies

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Section: Discussionsupporting

confidence: 87%

Incidence of hospital-acquired pressure ulcers in patients with "minimal risk" according to the "Norton-MI" scale

Díaz-Caro

Gómez-Heras

2020

PLoS ONE

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“…This finding is in line with previous surveys, which showed that the cost of treatment increases dramatically with PI‐stage increase; for example, Dealey et al (2012) reported that the expected cost in the UK was about 1200, 5200, 9000 and 14000 pounds‐per‐patient to heal a stage‐1, stage‐2, stage‐3 and stage‐4 PI, respectively. In a study conducted in Spain on a population of patients with PIs who were hospitalised in internal medicine units, Díez‐Manglano et al (2016) reported that DRGw was significantly higher ( p < 0.001) in patients with PIs of any stage (2.10 ± 0.96) than in patients without PIs (1.58 ± 0.96). To our knowledge, the present study is the first to report the impact of stage‐by‐stage CAPI on DRGw.…”

Section: Discussionmentioning

confidence: 99%

“…Among studies assessing PIs within eight hours of admission in hospitalised patients, the reported prevalence of CAPI ranged from 10.3 to 16.0% for acute medical or geriatric patients (Díez‐Manglano et al, 2016; Khor et al, 2014; Garcez Sardo et al, 2016) to 61.5–66.5% for patients suffering from advanced or terminal illnesses and requiring palliative care (Jaul & Calderon‐Margalit, 2015; Jaul et al, 2016). Inclusion criteria limited CAPI prevalence to PIs of at least stage‐2 (Khor et al, 2014) or stage‐3 and stage‐4 (Jaul & Calderon‐Margalit, 2015; Jaul et al, 2016), while among studies that included patients with stage‐1‐to‐stage‐4 PIs, unstageable injuries were not considered (Díez‐Manglano et al, 2016; Garcez Sardo et al, 2016). As far as can be seen from the retrieved literature, no study has analysed CAPI prevalence and the related short‐ and long‐term mortality according to the complete PIs staging.…”

Section: Introductionmentioning

confidence: 99%

Stage‐related implications of community‐acquired pressure injuries for the acute medical inpatients

Sanson

Barbin

Matteis

et al. 2020

Journal of Clinical Nursing

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Aims To analyse the prevalence of any‐stage pressure injuries at hospital admission and their impact on short‐, mid‐ and late‐term mortality. Patient characteristics associated with pressure injuries and the impact on hospital costs were also investigated. Background In medical patients acutely admitted to hospital, no study analysed the presence of pre‐existing pressure injuries and the related short‐ and long‐term mortality according to the overall stages of severity thereof. Design Retrospective cohort study following the STROBE guideline. Methods In a population of 7217 acute medical inpatients, the presence and staging of pressure injuries were assessed at hospital admission. The impact of pressure injury on 30‐, 180‐ and 365‐day mortality was analysed by multivariate Cox regression models. Results The prevalence of community‐acquired pressure injuries was 14.9% (stage‐1: 8.1%; stage‐2: 3.5%; stage‐3: 1.6%; stage‐4: 1.1%; unstageable: 0.5%). Hemiplegia/paraplegia, anaemia, poor functional status, high nutritional risk, clinical instability and systemic inflammatory response, but not hydration status, were found to be associated with the occurrence of stage‐2‐and‐above pressure injuries. An increasing difference was found in Diagnosis‐Related Groups (DRG) weight according to pressure injury stages. A distinct and progressively increasing risk‐of‐death for any‐stage pressure injury was shown after 365‐days. A significantly increased mortality risk for all considered time intervals was found for unstageable and stage‐4 pressure injuries. Conclusions In acute medical inpatients, the presence of community‐acquired pressure injuries is part of a multidimensional clinical complexity. The presence and staging of pressure injuries have an independent dramatic impact on of early‐to‐late mortality and hospital costs. Relevance to clinical practice This study documented as community‐acquired pressure injuries are highly prevalent and represents an independent predictor of outcomes in strict dependence of the progression of thereof stage. The presence of community‐acquired pressure injuries should be interpreted as a critical marker of frailty and increased vulnerability.

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“…Es preciso realizar una valoración integral y multidimensional de las personas ancianas hospitalizadas en Medicina Interna Las personas ancianas que son hospitalizadas presentan con frecuencia de forma precoz, una vez que han sido dadas Valoración integral y multidimensional del anciano hospitalizado 3 de alta, complicaciones no relacionadas con la enfermedad que motivó el ingreso 6 . El uso de los servicios hospitalarios los expone a peores resultados de la atención sanitaria, muchos de los cuales no están directamente relacionadas con el diagnóstico primario 7,8 . Estas complicaciones son consecuencia también de la práctica hospitalaria y de los tratamientos médicos 9 .…”

Section: Recomendacionesunclassified

Recomendaciones sobre la valoración integral y multidimensional del anciano hospitalizado. Posicionamiento de la Sociedad Española de Medicina Interna

Maroto

Romano

Nogueroles³

et al. 2021

Revista Clínica Española

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Úlceras por presión en pacientes ingresados en Medicina Interna: factores asociados y mortalidad

Cited by 9 publications

References 18 publications

Incidence of hospital-acquired pressure ulcers in patients with "minimal risk" according to the "Norton-MI" scale

Incidence of hospital-acquired pressure ulcers in patients with "minimal risk" according to the "Norton-MI" scale

Stage‐related implications of community‐acquired pressure injuries for the acute medical inpatients

Recomendaciones sobre la valoración integral y multidimensional del anciano hospitalizado. Posicionamiento de la Sociedad Española de Medicina Interna

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