Naslov
Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Autori
Labeau, Sonia O. ; on behalf of the DecubICUs Study Team ; Afonso, Elsa ; Benbenishty, Julie ; Blackwood, Bronagh ; Boulanger, Carole ; Brett, Stephen J. ; Calvino-Gunther, Silvia ; Chaboyer, Wendy ; Coyer, Fiona ; Deschepper, Mieke ; François, Guy ; Honore, Patrick M. ; Jankovic, Radmilo ; Khanna, Ashish K. ; Llaurado-Serra, Mireia ; Lin, Frances ; Rose, Louise ; Rubulotta, Francesca ; Saager, Leif ; Williams, Ged ; Blot, Stijn I. ; the European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators

Kolaboracija
DecubICUs Study Team and the European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators

Izvornik
Intensive Care Medicine (0342-4642) 47 (2021), 4; 503-520

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Decubitus epidemiology, ICU, Pressure injury, Pressure ulcer, Outcome, Risk factors, Morbidity, Mortality

Sažetak
Abstract Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and fac‑ tors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study ; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU- acquired pressure injury and hospital mortality were assessed by generalised linear mixed-efects regression analysis. Results: Data from 13, 254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries ; 3997 (59.2%) were ICUacquired. Overall prevalence was 26.6% (95% confdence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most afected. Factors independently associated with ICU-acquired pres‑ sure injuries were older age, male sex, being underweight, emergency surgery, higher Simplifed Acute Physiology Score II, Braden score <19, ICU stay >3 days, comorbidities (chronic obstructive pulmonary disease, immunodefciency), organ sup‑ port (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identifed for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5 ; 95% CI 1.2–1.8), stage II (OR 1.6 ; 95% CI 1.4–1.9), and stage III or worse (OR 2.8 ; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne tehničke znanosti, Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

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