Schlüer Anna-Barbara, Halfens Ruud J, Schols Jos M G A
Section of Nursing Science, Children's Research Center, Children's University Hospital Zurich, Zurich, Switzerland.
Ostomy Wound Manage. 2012 Jul;58(7):18-31.
Pressure ulcers (PUs) are a common concern for hospitalized children and adults, but knowledge about PU risk factors,prevalence, and incidence rates among children remains limited. To assess the prevalence of and risk factors for PUs in pediatric care settings, a 1-day cross-sectional study was conducted among all hospitalized children ages 0 to 18 years in all 14 pediatric hospitals in the German-speaking part of Switzerland. Data collection involved a direct systematic inspection and assessment of the skin. A standardized data collection instrument was used, and each patient was assessed by a previously instructed rater pair. The total number of participating children was 412 (75% of all hospitalized children). An overall PU prevalence of 35% (including European Pressure Ulcer Advisory Panel category 1 ulcers) was observed. Most patients with PUs (80%) had category 1 ulcers. The prevalence rate was highest among patients in the pediatric intensive care unit (PICU) (16/36, 44%), followed by the department of neonatology (47/109, 43%). The presence of a PU was significantly higher among patients with a medical device, who were young (<1 year old), had a longer length of stay, and low Braden scale score (P <0.05). Rates also varied by institution (P <0.05). Department, patient age,Braden scale score, and institution explained 25% of the variance in PU prevalence. The prevalence of PUs in pediatric patients is higher than expected, and the rate of category 1 PUs suggests that interventions to prevent PUs are needed,especially in the high-risk patients identified. Future studies are needed to further assess these risk factors, especially for patients in PICUs.
压疮是住院儿童和成人普遍关注的问题，但关于儿童压疮危险因素、患病率和发病率的知识仍然有限。为评估儿科护理环境中压疮的患病率和危险因素，在瑞士德语区的所有14家儿科医院对0至18岁的所有住院儿童进行了为期1天的横断面研究。数据收集包括对皮肤进行直接系统检查和评估。使用标准化的数据收集工具，每位患者由预先接受培训的评估人员对进行评估。参与研究的儿童总数为412名（占所有住院儿童的75%）。观察到总体压疮患病率为35%（包括欧洲压疮咨询小组1类溃疡）。大多数压疮患者（80%）为1类溃疡。患病率在儿科重症监护病房（PICU）患者中最高（16/36，44%），其次是新生儿科（47/109，43%）。使用医疗器械、年龄小（<1岁）、住院时间长且Braden量表评分低的患者中压疮的发生率显著更高（P<0.05）。患病率在不同机构之间也存在差异（P<0.05）。科室、患者年龄、Braden量表评分和机构解释了压疮患病率25%的变异。儿科患者压疮的患病率高于预期，1类压疮的发生率表明需要采取预防压疮的干预措施，尤其是在已确定的高危患者中。需要进一步开展研究以评估这些危险因素，特别是针对PICU患者。
