Horn Susan D, Bender Stacy A, Bergstrom Nancy, Cook Abby S, Ferguson Maree L, Rimmasch Holly L, Sharkey Siobhan S, Smout Randall J, Taler George A, Voss Anne C
ISIS, Inc., Salt Lake City, Utah, USA.
J Am Geriatr Soc. 2002 Nov;50(11):1816-25. doi: 10.1046/j.1532-5415.2002.50510.x.
To describe and provide baseline data from The National Pressure Ulcer Long-Term Care Study (NPULS).
Retrospective cohort study of detailed resident characteristics, treatments, and outcomes using convenience sampling.
One hundred nine long-term care facilities throughout the United States.
Two thousand four hundred twenty adult residents aged 18 and older, with a length of stay of 14 days or longer and who were at risk of developing a pressure ulcer, as defined by a Braden Scale for Predicting Pressure Sore Risk
More than 500 characteristics were obtained for each resident over a 12-week period. This paper describes the NPULS database with respect to the resident (sex, age, diagnoses, severity of illness scores, Braden Scale score, activities of daily living, cognitive ability, mobility, bowel or bladder incontinence, laboratory values, nutritional assessment, and pressure ulcer assessment documentation), treatment (nutritional interventions, pressure relieving devices, incontinence interventions, protective devices, turning schedules, and pressure ulcer treatments), and outcome variables (pressure ulcer development and healing, pressure ulcer and systemic infection, changes in nutritional status, and discharge disposition) associated with pressure ulcers. Descriptive statistics and bivariate associations were used for preliminary analyses of resident, treatment, and outcome characteristics.
The average age +/- standard deviation was 79.7 +/- 14.2; 70% of the residents were female. Fifty-three percent of residents (n = 1,293) were at risk of developing a pressure ulcer but never developed one during the study (Group 1), 19% developed a new pressure ulcer during the study (n = 457) (Group 2), 22% had an existing pressure ulcer (n = 534) (Group 3), and 6% had an existing pressure ulcer and developed a new ulcer during the study (n = 136) (Group 4). Residents who developed a new pressure ulcer (Group 2) were more likely to be female, older, cognitively impaired, and immobile than residents who had an existing pressure ulcer (Group 3).
This baseline study describes the NPULS database with respect to the resident, treatment, and outcome variables associated with pressure ulcers. Future studies will focus on multivariate analyses for risk factor prediction of pressure ulcer development and pressure ulcer healing. Research-based pressure ulcer prevention and treatment protocols can then be developed.
描述并提供国家压疮长期护理研究（NPULS）的基线数据。
采用便利抽样对详细的居民特征、治疗方法和结果进行回顾性队列研究。
美国109家长期护理机构。
2420名18岁及以上的成年居民，住院时间为14天或更长，且根据预测压疮风险的Braden量表被判定有发生压疮的风险。
在12周的时间内，为每位居民获取了500多项特征。本文描述了NPULS数据库中关于居民（性别、年龄、诊断、疾病严重程度评分、Braden量表评分、日常生活活动能力、认知能力、活动能力、大小便失禁情况、实验室检查值、营养评估以及压疮评估记录）、治疗（营养干预、减压装置、失禁干预、防护装置、翻身计划以及压疮治疗）以及与压疮相关的结局变量（压疮的发生与愈合、压疮与全身感染、营养状况变化以及出院处置）的情况。描述性统计和双变量关联分析用于对居民、治疗方法和结局特征进行初步分析。
平均年龄±标准差为79.7±14.2；70%的居民为女性。53%的居民（n = 1293）有发生压疮的风险，但在研究期间未发生（第1组），19%在研究期间发生了新的压疮（n = 457）（第2组），22%有现患压疮（n = 534）（第3组），6%有现患压疮且在研究期间发生了新的压疮（n = 136）（第4组）。与有现患压疮的居民（第3组）相比，发生新压疮的居民（第2组）更可能为女性、年龄更大、有认知障碍且活动能力差。
这项基线研究描述了NPULS数据库中与压疮相关的居民、治疗方法和结局变量。未来的研究将侧重于对压疮发生和愈合的危险因素预测进行多变量分析。进而可以制定基于研究的压疮预防和治疗方案。
