Santaeugènia Sebastià J, Mas Miquel Àngel, Tarazona-Santabalbina Francisco J, Alventosa Ana Maria, García Manoli, Monterde Albert, Gutiérrez Alicia, Cunill Joan
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Nutr Hosp. 2017 Nov 16;34(5):1305-1310. doi: 10.20960/nh.1065.
A retrospective cohort study was performed in order to evaluate the prevalence of pressure ulcers (PrUs) in older patients admitted to a geriatric rehabilitation unit of a postacute care hospital and to investigate the impact of the presence of PrUs on clinical outcomes of the rehabilitation process.
We studied 668 post-acute patients consecutively attended, from January 2010 to December 2011. The effect of having PrUs at admission was evaluated based on its impact on outcomes: final destination, functional status, mortality and length of stay in the rehabilitation unit.
PrUs prevalence at admission was 16%. Patients with PrUs were older, more disabled and had more complex conditions, including malnutrition and cognitive impairment. In the bivariate analysis, we found patients with PrUs at admission had worst final outcome (%): discharge home (69.2 vs.82.5), discharge long term care setting (14 vs.6.4), discharge acute care (8.4 vs.6.2) and death (8.4 vs.4.8); p < 0.001, and worst Barthel Index score at discharge 57 (SD 34.1) vs.83 (SD 33.6); p < 0.001, with longer length of stay in the unit 61 (SD 42.3) vs.53 (SD 37.1); p 0.004. In the multivariate analysis, PrUs presence was found as one of the variables with significant association to no return to home. Finally, a negative association between PrUs at admission and functional gain at discharge of the postacute unit was identified.
PrUs were prevalent and had negative impact on clinical outcomes of our geriatric unit, as discharge destination, functional gain and Length of Stay, in vulnerable patients.
开展一项回顾性队列研究，以评估入住一家急性后护理医院老年康复科的老年患者中压疮的患病率，并调查压疮的存在对康复过程临床结局的影响。
我们研究了2010年1月至2011年12月期间连续收治的668例急性后患者。根据压疮对结局的影响评估入院时患有压疮的影响：最终去向、功能状态、死亡率和在康复科的住院时间。
入院时压疮患病率为16%。患有压疮的患者年龄更大、残疾程度更高且病情更复杂，包括营养不良和认知障碍。在双变量分析中，我们发现入院时患有压疮的患者最终结局更差（百分比）：出院回家（69.2%对82.5%）、出院至长期护理机构（14%对6.4%）、出院至急性护理机构（8.4%对6.2%）和死亡（8.4%对4.8%）；p<0.001，出院时Barthel指数评分更差，分别为57（标准差34.1）对83（标准差33.6）；p<0.001，在康复科的住院时间更长，分别为61天（标准差42.3）对53天（标准差37.1）；p = 0.004。在多变量分析中，发现压疮的存在是与未回家显著相关的变量之一。最后，确定入院时压疮与急性后护理单元出院时的功能改善之间存在负相关。
在脆弱患者中，压疮很常见，并且对我们老年科室的临床结局有负面影响，如出院去向、功能改善和住院时间。
