Yepes David, Molina Francisco, León Wleedy, Pérez Edna
Anestesiología y Cuidado Intensivo, Clínica Bolivariana y Clínica CES, Grupo Cuidado Crítico Universidad CES, Medellín, Colombia.
Med Intensiva. 2009 Aug-Sep;33(6):276-81. doi: 10.1016/S0210-5691(09)72195-3.
The incidence of pressure ulcers in the literature varies from 4.7% to 18.6%. In our study, we have aimed to identify the incidence and risk factors associated with the occurrence of pressure ulcers in critically ill patients.
Medical-surgical intensive care unit.
Prospective observational study in the period of September 2005 to August 2006.
We included patients without PU on admission who were hospitalized more than 48 hours in the intensive care unit (ICU) and who had any of the following risk factors for pressure ulcers: intubated and on mechanical ventilation, with vasopressor support. Main variable interest: The main variable was the presence of grade II or higher PU. Other variables studied were age, weight, body mass index, admission diagnosis, presence of infection, APACHE II (Acute Physiologic and Chronic Health Evaluation), ventilation mechanical level of sedation, presence of diarrhea, wound drainage, vasopressor support, duration of mechanical ventilation, ICU and hospital stay.
The study included 150 patients, with an average age of 54 years, the APACHE II averaged 18.2+/-8.2, 88.67% of the patients were on mechanical ventilation, days of stay in ICU were an average of 11.94+/-16.45. Percentage of PU grade II or higher was 26.7%. After the univariate analysis, the risk factors found were presence of infection (OR=2.52 with a p-value=0.013 and a 95% CI, 1.2-5.29), days of stay in ICU (p=0.001; OR=4.39; 95% CI, 6.92-18.25). Presence of infection (OR=2.89; p=0.023; 95% CI, 1.16-7.22), days of stay in the ICU (OR=1.13; p=0.005; 95% CI, 1.06,1.22) and a high score APACHE II (OR=1.06; p=0.044; 95% CI, 1-1.12) were also significant in the multivariate analysis.
The incidence of pressure ulcers in the study population is very high. The risk factors most often found are presence of infection, days of stay and high APACHE II score.
文献中压疮的发生率在4.7%至18.6%之间。在我们的研究中，我们旨在确定重症患者中压疮发生的发生率及相关风险因素。
内科-外科重症监护病房。
2005年9月至2006年8月期间的前瞻性观察研究。
我们纳入了入院时无压疮、在重症监护病房（ICU）住院超过48小时且有以下任何压疮风险因素的患者：插管并接受机械通气、使用血管活性药物支持。主要关注变量：主要变量是II级或更高级别的压疮的存在情况。研究的其他变量包括年龄、体重、体重指数、入院诊断、感染情况、急性生理与慢性健康状况评估II（APACHE II）、机械通气时的镇静水平、腹泻情况、伤口引流、血管活性药物支持、机械通气持续时间、ICU住院时间和住院时间。
该研究纳入了150名患者，平均年龄54岁，APACHE II评分为18.2±8.2，88.67%的患者接受机械通气，ICU平均住院天数为11.94±16.45天。II级或更高级别压疮的发生率为26.7%。单因素分析后，发现的风险因素为感染（OR=2.52，p值=0.013，95%置信区间为1.2 - 5.29）、ICU住院天数（p=0.001；OR=4.39；95%置信区间为6.92 - 18.25）。在多因素分析中，感染（OR=2.89；p=0.023；95%置信区间为1.16 - 7.22）、ICU住院天数（OR=1.13；p=0.005；95%置信区间为1.06,1.22）和高APACHE II评分（OR=1.06；p=0.044；95%置信区间为1 - 1.12）也具有显著性。
研究人群中压疮的发生率非常高。最常发现的风险因素是感染、住院天数和高APACHE II评分。
