Surgical Intensive Care Unit, Yale-New Haven Hospital, New Haven, CT 06504, USA.
J Wound Ostomy Continence Nurs. 2010 Nov-Dec;37(6):619-26. doi: 10.1097/WON.0b013e3181f90a34.
We sought to describe the occurrence of pressure ulcers in patients managed in a surgical intensive care unit (ICU) and report preliminary work toward development of a pressure ulcer risk assessment tool for use in this population that incorporates comorbidities and other factors not addressed in previous instruments.
Three hundred sixty-nine patients managed in the surgical ICU at Yale-New Haven Hospital comprised the sample.
Demographic and clinical data, including Braden Scale scores, were collected in this prospective, 2-phase study. The principal investigator (G.C.S.) performed skin assessments on all patients. We used chi-square analysis and t tests to determine variables to include in a stepwise logistic regression analysis to determine factors independently associated with the development of pressure ulcers.
We collected data, using a form we developed that contained demographic and clinical factors found in previous research and in our clinical practice to be associated with pressure ulcers.
Eighty-eight out of 369 patients (23.9%) experienced a hospital-acquired pressure ulcer. Braden Scale scores ranged from 6 to 21, with a mean score of 11.9 ± 2.2. A lower Braden Scale score, the presence of diabetes mellitus, and patient age 70 years or older independently predicted the development of a pressure ulcer. These factors have been incorporated into the preliminary Surgical ICU Pressure Ulcer Risk Assessment scale.
Findings from this study suggest that, in addition to a low Braden Scale score, age >70 years and a diagnosis of diabetes may represent clinically relevant pressure ulcer risk factors in the surgical intensive care population and that patients with these factors may benefit from more aggressive preventive care. In addition, the Surgical ICU Pressure Ulcer Risk Assessment scale requires additional psychometric testing before its use can be recommended for the research or practice settings.
我们旨在描述外科重症监护病房（SICU）患者发生压疮的情况，并报告开发一种用于该人群的压疮风险评估工具的初步工作，该工具纳入了既往工具未涉及的合并症和其他因素。
本研究的样本包括在耶鲁-纽黑文医院外科 SICU 接受治疗的 369 名患者。
在这项前瞻性的 2 期研究中收集了人口统计学和临床数据，包括布雷登量表评分。主要研究者（G.C.S.）对所有患者进行了皮肤评估。我们使用卡方分析和 t 检验来确定变量，以便纳入逐步逻辑回归分析，以确定与压疮发生独立相关的因素。
我们使用我们开发的表格收集数据，该表格包含了先前研究和我们临床实践中发现的与压疮相关的人口统计学和临床因素。
369 名患者中有 88 名（23.9%）发生了医院获得性压疮。布雷登量表评分为 6 至 21 分，平均评分为 11.9±2.2。较低的布雷登量表评分、患有糖尿病以及患者年龄 70 岁或以上独立预测压疮的发生。这些因素已纳入初步的外科 SICU 压疮风险评估量表。
本研究的结果表明，除了低布雷登量表评分外，年龄 >70 岁和糖尿病诊断可能代表外科重症监护人群中具有临床意义的压疮危险因素，具有这些因素的患者可能需要更积极的预防护理。此外，外科 SICU 压疮风险评估量表在研究或实践环境中使用之前需要进一步的心理测量测试。
