Nursing Department, University of Valencia, Valencia, Spain.
University Hospital of Valencia, Valencia, Spain.
Int Wound J. 2018 Aug;15(4):571-579. doi: 10.1111/iwj.12900. Epub 2018 Jun 13.
Epidemiological studies on pressure ulcers (PUs) in hospitalised infants are scarce. Spain lacks comprehensive research studies providing data on the prevalence or incidence in this population. This work was developed to determine the incidence of PUs in hospitalised infants admitted to intensive and intermediate care units, along with relevant risk factors and preventive measures. A prospective study appraising the incidence of PUs in infants was performed. The risk factors and preventive measures were evaluated using a multivariate logistic regression model. A sample of 268 infants was included. The cumulative incidence of PUs was 12.70% (95% confidence interval, CI = [8.95%-17.28%]). The cumulative incidence in the intermediate care units was 1.90% (CI = [0.39%-5.45%]), while it was 28.18% (CI = [20.02%-37.56%]) in the intensive care units. The PUs were categorised as stage I, 57.10%; stage II, 31.70%; and stage III, 11.10%. The multivariate analysis found the following to be risk factors: low scores in the Spanish version of the Neonatal Skin Risk Assessment Scale (e-NSRAS) (Relative Risk (RR) 0.80; CI = [0.66-0.97]), the use of non-invasive mechanical ventilation (RR 12.24; CI = [4.02-37.32]), and the length of stay (RR 1.08; CI = [1.02-1.15]), suggesting a direct impact of these factors on PU development in infants. Kangaroo care influenced the prevention of PUs (RR 0.26; CI = [0.09-0.71]). The infants admitted in intermediate care units suffered PUs. In the case of intensive care units, the incidence is even higher. The risk increases with the length of stay, while the presence of medical devices, particularly non-invasive mechanical ventilation, is the main causal relationship. Kangaroo care has been shown to be an important preventive measure.
在住院婴儿中，压疮（PU）的流行病学研究很少。西班牙缺乏全面的研究，无法提供该人群中患病率或发病率的数据。本研究旨在确定入住重症监护病房和中级护理病房的住院婴儿的 PU 发生率，以及相关的危险因素和预防措施。对婴儿的 PU 发生率进行了前瞻性研究。使用多变量逻辑回归模型评估了危险因素和预防措施。纳入了 268 名婴儿的样本。PU 的累积发生率为 12.70%（95%置信区间，CI=[8.95%-17.28%]）。中级护理病房的累积发生率为 1.90%（CI=[0.39%-5.45%]），而重症监护病房的累积发生率为 28.18%（CI=[20.02%-37.56%]）。PU 分为 1 期，占 57.10%；2 期，占 31.70%；3 期，占 11.10%。多变量分析发现以下因素为危险因素：西班牙版新生儿皮肤风险评估量表（e-NSRAS）评分低（相对风险（RR）0.80；CI=[0.66-0.97]）、使用无创机械通气（RR 12.24；CI=[4.02-37.32]）和住院时间（RR 1.08；CI=[1.02-1.15]），这表明这些因素对婴儿 PU 的发展有直接影响。袋鼠式护理影响 PU 的预防（RR 0.26；CI=[0.09-0.71]）。中级护理病房的婴儿发生了 PU。在重症监护病房，发病率甚至更高。随着住院时间的延长，风险增加，而医疗器械的存在，特别是无创机械通气，是主要的因果关系。袋鼠式护理已被证明是一种重要的预防措施。
