Predictors of Pressure Injuries in a Critical Care Unit in Lebanon
| Autor: | Bana El Zein, Jihad El-Marsi, Salah Zein-El-Dine, Rita Doumit, Lina Kurdahi Badr |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Severity of Illness Index law.invention 03 medical and health sciences 0302 clinical medicine Risk Factors law Severity of illness Prevalence Humans Vasoconstrictor Agents Medicine 030212 general & internal medicine Lebanon Aged Retrospective Studies Aged 80 and over Pressure Ulcer Advanced and Specialized Nursing 030504 nursing business.industry Critically ill Medical record Retrospective cohort study Odds ratio Length of Stay Middle Aged Intensive care unit Confidence interval Intensive Care Units Medical–Surgical Nursing Emergency medicine Female Hypotension 0305 other medical science business |
| Zdroj: | Journal of Wound, Ostomy & Continence Nursing. 45:131-136 |
| ISSN: | 1071-5754 |
| Popis: | Purpose The purpose of this study was to identify factors associated with pressure injury in a medical-surgical intensive care unit (MSICU). Design Retrospective review of medical records. Subjects and setting We reviewed the medical records of 145 patients who developed a new pressure injury in the MSICU of a 420-bed university medical center in Lebanon. Methods Medical records of all patients cared for in the MSICU from December 2014 to June 2017 were reviewed by a research assistant using a standardized form. We extracted potential risk factors for pressure injury including sex, age, weight upon admission, weight at discharge, length of MSICU stay, episodes of hypotension, administration of inotropes/vasopressors, admitting diagnosis, comorbid conditions, and cumulative scores on the Braden Scale for Pressure Sore Risk. The outcome variable was development of any new pressure injury during their stay in our intensive care unit. Results Forty-nine patents (33.7%) developed a new pressure injury. Bivariate analysis found statistically significant associations between pressure injury occurrences and administration of vasopressors (odds ratio [OR] = 0.42; 95% confidence interval = 0.29-0.87; P = .02), the administration of dopamine (OR = 0.20; 95% confidence interval = 0.04-0.94; P = .04), and hospital-acquired pressure injury. Among the continuous variables, analysis revealed significant relationships between weight at discharge (t = 2.31, P = .02), MSICU length of stay (t = 5.30; P = .000), cumulative Braden Scale score (t = 3.06; P = .002), hypotension (t =-2.74; P = .007), and development a new pressure injury. Multivariate analysis indicated that length of stay (β= -.110; P = .002), administration of vasopressors (β=-.266; P = .029), and total hours of hypotension (β=-.53; P = .041) were significant predictors of pressure injury. Conclusions Vasopressor use, hypotension, and length of stay were associated with an increased likelihood of pressure injury in adults managed in an MSICU. None of these factors is specifically evaluated during completion of the Braden Scale for Pressure Sore Risk. Based on these findings we recommend development of a pressure injury scale specific to critically ill adults. |
| Databáze: | OpenAIRE |
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