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Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit.

Abstract：

AIMS AND OBJECTIVES:To determinate the incidence, incidence rate and risk factors of pressure ulcers in critical care patients. BACKGROUND:Pressure ulcers represent one of the most frequent health problems in clinical practice. Specifically, critical patients who are hospitalised in intensive care units have a higher risk of developing a pressure ulcer, with an incidence that fluctuates between 3.3-39.3% according to previous studies. DESIGN:Prospective cohort study. METHODS:Three hundred and thirty-five adult patients (over 18 years old) who were hospitalised in intensive care units for at least 24 hr were monitored for a maximum of 32 days. They were excluded if they had a pressure ulcers at admission. The survival rate for pressure ulcers, from stages I-IV, was calculated using the Kaplan-Meier method. A multivariate Cox regression model was adjusted to identify the main risk factors for pressure ulcers: demographic, clinical, prognostic and therapeutic variables. RESULTS:The incidence of pressure ulcers in critical patients was 8.1%, and the incidence rate was 11.72 pressure ulcers for 1,000 days of intensive care units stay; 40.6% of pressure ulcers were of stage I and 59.4% of stage II, mainly in the sacrum. According to the Cox model, the main risk factors for pressure ulcers were in-hospital complications, prognostic scoring system (SAPS III) and length of immobilisation. CONCLUSIONS:The incidence of pressure ulcers is lower than that shown in recent studies. Complications on the unit and the prognosis score were risk factors associated with pressure ulcers but, surprisingly, length of immobilisation was a protective factor. RELEVANCE TO CLINICAL PRACTICE:Survival analysis of pressure ulcer allows for identification of risk factors associated with this health problem in the intensive care units. Identifying these factors can help nurses establish interventions to prevent pressure ulcers in this healthcare scenario, given that pressure ulcers prevention is an indicator of nursing quality.

journal_name

J Clin Nurs

journal_title

Journal of clinical nursing

authors

González-Méndez MI,Lima-Serrano M,Martín-Castaño C,Alonso-Araujo I,Lima-Rodríguez JS

doi

10.1111/jocn.14091

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

1028-1037

issue

5-6

eissn

0962-1067

issn

1365-2702

journal_volume

pub_type

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Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit.