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重症监护病房压疮的发生率及直接治疗成本:来自伊朗的证据。

Incidence of pressure ulcers in intensive care units and direct costs of treatment: Evidence from Iran.

作者信息

Zarei Ehsan, Madarshahian Elmira, Nikkhah Adeleh, Khodakarim Soheila

机构信息

Department of Health Services Management, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Health Services Management, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Tissue Viability. 2019 May;28(2):70-74. doi: 10.1016/j.jtv.2019.02.001. Epub 2019 Feb 15.

Abstract

BACKGROUND AND OBJECTIVE

Pressure ulcer (PU) is one of the important and frequent complications of hospitalization, associated with high treatment costs. The present study was conducted to determine the incidence of PU and its direct treatment costs for patients in intensive care unit (ICU) in Iran.

MATERIAL AND METHODS

In this retrospective study, medical records of 643 discharged patients from ICU of two selected hospitals were examined. The demographic and clinical data of all patients and data of resources and services usage for patients with PU were extracted through their records. Data analysis was done using logistic regression tests in SPSS 22 software. The cost of PU treatment was calculated for each grade of ulcer.

RESULTS

The findings showed that 8.9% of patients developed PU during their stay in ICU. Muscular paralysis (OR = 5.1), length of stay in ICU (OR = 4.0), diabetes (OR = 3.5) age (OR = 2.9), smoking (OR = 2.1) and trauma (OR = 1.4) were the most important risk factors of PU. The average cost of PU treatment varied from USD 12 for grade I PU to USD 66 834 for grade IV PUs. The total treatment costs for all studied patients with PU was estimated at USD 519 991.

CONCLUSION

The cost of PU treatment is significant. Since the preventive measures are more cost-effective than therapeutic measures, therefore, effective preventive interventions are recommended.

摘要

背景与目的

压疮(PU)是住院期间重要且常见的并发症之一,治疗费用高昂。本研究旨在确定伊朗重症监护病房(ICU)患者中压疮的发生率及其直接治疗费用。

材料与方法

在这项回顾性研究中,对两家选定医院ICU出院的643例患者的病历进行了检查。通过病历提取所有患者的人口统计学和临床数据以及压疮患者的资源和服务使用数据。使用SPSS 22软件中的逻辑回归测试进行数据分析。计算每个溃疡等级的压疮治疗费用。

结果

研究结果显示,8.9%的患者在ICU住院期间发生了压疮。肌肉麻痹(OR = 5.1)、ICU住院时间(OR = 4.0)、糖尿病(OR = 3.5)、年龄(OR = 2.9)、吸烟(OR = 2.1)和创伤(OR = 1.4)是压疮最重要的危险因素。压疮治疗的平均费用从I级压疮的12美元到IV级压疮的66834美元不等。所有研究的压疮患者的总治疗费用估计为519991美元。

结论

压疮治疗费用高昂。由于预防措施比治疗措施更具成本效益,因此建议采取有效的预防干预措施。

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