Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Department Health Care, VIVES University College, Roeselare, Belgium.
Int Wound J. 2019 Apr;16(2):325-333. doi: 10.1111/iwj.13032. Epub 2018 Nov 9.
The aim of this study was to identify independent risk factors for pressure ulcer (PU) development in a high-risk nursing home population receiving evidence-based PU prevention. This study was part of a randomised controlled trial examining the (cost-)effectiveness of static air support surfaces compared with alternating pressure air mattresses. The sample consisted of 308 residents at a high risk of PU development (presence of non-blanchable erythema, Braden score ≤ 12 or Braden subscale "mobility" ≤ 2). PU incidence was monitored for 14 days. Demographic variables; functional, physical, and psychological characteristics; and data on skin assessment were collected. Independent risk factors were identified using multiple logistic regression analysis. The overall PU incidence (category II-IV) was 8.4% (n = 26), and 1.9% (n = 6) of the residents developed a deep PU (category III-IV). PUs (category II-IV) were significantly associated with non-blanchable erythema, a lower Braden score, and pressure area-related pain in high-risk residents even if preventive care was provided. These results highlight the need of a systematic risk assessment, including pain assessment and skin observations, in order to determine and tailor preventive care to the needs of high-risk individuals.
本研究旨在确定在接受基于证据的压疮（PU）预防的高风险养老院人群中，PU 发展的独立风险因素。本研究是一项随机对照试验的一部分，该试验检查了静态空气支撑面与交替压力气垫相比的（成本）效果。该样本由 308 名有 PU 发展高风险的居民组成（存在不可褪色红斑、Braden 评分≤12 或 Braden 亚量表“活动度”≤2）。监测了 14 天的 PU 发生率。收集了人口统计学变量；功能、身体和心理特征；以及皮肤评估数据。使用多变量逻辑回归分析确定了独立的风险因素。总的 PU 发生率（类别 II-IV）为 8.4%（n=26），6%（n=6）的居民出现了深部 PU（类别 III-IV）。即使提供了预防护理，高风险居民的不可褪色红斑、较低的 Braden 评分和与压力相关的疼痛与 PU（类别 II-IV）显著相关。这些结果强调需要进行系统的风险评估，包括疼痛评估和皮肤观察，以确定和调整高危个体的预防护理。
