Hobson Deborah B, Chang Tracy Y, Aboagye Jonathan K, Lau Brandyn D, Shihab Hasan M, Fisher Betsy, Young Samantha, Sujeta Nancy, Shaffer Dauryne L, Popoola Victor O, Kraus Peggy S, Knorr Gina, Farrow Norma E, Streiff Michael B, Haut Elliott R
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD.
New York Medical College, School of Medicine, Valhalla, NY.
J Crit Care. 2017 Aug;40:1-6. doi: 10.1016/j.jcrc.2017.02.016. Epub 2017 Feb 27.
This study aimed to determine the prevalence of static graduated compression stocking (sGCS)-associated pressure injury among patients in surgical intensive care units (ICUs).
We retrospectively reviewed data from wound care rounds between April 2011 and June 2012 at 3 surgical ICUs at an urban, tertiary care hospital. Patients with sGCS-associated pressure injury were identified and descriptive analysis was performed on their demographic, perioperative, and postoperative characteristics.
We examined 1787 individual patients during 2391 patient encounters. A total of 129 (7.2%) of patients developed pressure injuries. Forty patients (2.2%) developed sGCS-associated pressure injury. Static GCS-associated pressure injury accounted for 31% (40/129) of all pressure injuries and 74% (40/54) of all medical device-related pressure injury. Eighteen (45%) and 6 (15%) developed stage 1 and 2 pressure injury, respectively, and 16 (40%) developed deep tissue injuries. The mean age of our patients was 64.7 years, about half (47.5%) were male, and their mean Acute Physiology and Chronic Health Evaluation II score was 18.8. Many had comorbid conditions, including obesity (44.5%) and diabetes (42.5%), and required mechanical ventilation (45%).
Pressure injuries are a notable complication of sGCS in surgical ICU patients. Appropriate measures are required to help avoid this potentially preventable harm.
本研究旨在确定外科重症监护病房（ICU）患者中静态渐进性加压弹力袜（sGCS）相关压力性损伤的发生率。
我们回顾性分析了一家城市三级医院3个外科ICU在2011年4月至2012年6月期间伤口护理查房的数据。识别出发生sGCS相关压力性损伤的患者，并对其人口统计学、围手术期和术后特征进行描述性分析。
我们在2391次患者诊疗过程中检查了1787例个体患者。共有129例（7.2%）患者发生了压力性损伤。40例（2.2%）患者发生了sGCS相关压力性损伤。静态GCS相关压力性损伤占所有压力性损伤的31%（40/129），占所有医疗器械相关压力性损伤的74%（40/54）。分别有18例（45%）和6例（15%）发生了1期和2期压力性损伤，16例（40%）发生了深部组织损伤。我们患者的平均年龄为64.7岁，约一半（47.5%）为男性，其平均急性生理与慢性健康状况评分II为18.8。许多患者有合并症，包括肥胖（44.5%）和糖尿病（42.5%），并需要机械通气（45%）。
压力性损伤是外科ICU患者使用sGCS时的一种显著并发症。需要采取适当措施来避免这种潜在的可预防伤害。
