School of Nursing, Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Queensland, Australia.
J Clin Nurs. 2020 Apr;29(7-8):1074-1084. doi: 10.1111/jocn.15156. Epub 2020 Jan 20.
To validate the ability of factors to predict infection in adults with chronic leg ulcers over a 12-week period.
Leg ulcers affect ~3% of older adults and are often hard to heal. Infection is a leading contributor for delayed healing, causing delayed wound healing, increased hospitalisation, increased healthcare costs and reduced patient quality of life. The importance of early identification of infection has been highlighted for decades, yet little is known about factors that are associated with increased risk of infection in this specific population.
A longitudinal, prospective observational study in a single centre.
Between August 2017 and May 2018, a total of 65 adults with chronic leg ulcers were prospectively observed for a 12-week period. Patients were recruited from an outpatient wound clinic at a tertiary hospital in Australia. Data were collected from recruitment (baseline) and each visit (weekly or fortnightly) up until 12 weeks. Descriptive statistics were calculated for all variables. A Cox proportional hazards regression model was used to identify predictive factors for infection. The TRIPOD guidelines for reporting were followed (See Data S1).
The sample consisted of 65 adults with chronic leg ulcers, and 9.2% of these had their ulcer infected at baseline. Two predictive factors, using walking aids and gout, were found to be significantly related to increased likelihood of developing infection within 12 weeks.
The present study showed that patients who either used walking aids or were diagnosed with gout were at greater risk of infection compared to those without these factors.
These findings provide new information for clinicians in early identification of patients at risk of infection, and for patients in enhancing their awareness of their own risk.
在 12 周的时间内，验证预测成年人慢性腿部溃疡感染的因素的能力。
腿部溃疡影响约 3%的老年人，且常常难以愈合。感染是导致愈合延迟的主要原因，会导致伤口愈合延迟、住院时间延长、医疗费用增加和患者生活质量降低。数十年来，人们一直强调早期识别感染的重要性，但对于哪些因素与该特定人群的感染风险增加相关知之甚少。
在单一中心进行的纵向、前瞻性观察性研究。
在 2017 年 8 月至 2018 年 5 月期间，共有 65 名患有慢性腿部溃疡的成年人在 12 周的时间内进行了前瞻性观察。患者是从澳大利亚一家三级医院的门诊伤口诊所招募的。从招募（基线）和每次就诊（每周或每两周）收集数据，直到 12 周。对所有变量进行描述性统计。使用 Cox 比例风险回归模型确定感染的预测因素。本研究遵循了 TRIPOD 报告指南（见数据 S1）。
该样本由 65 名患有慢性腿部溃疡的成年人组成，其中 9.2%的人在基线时溃疡感染。发现使用助行器和痛风这两个预测因素与 12 周内发生感染的可能性增加显著相关。
本研究表明，与没有这些因素的患者相比，使用助行器或被诊断为痛风的患者感染的风险更高。
这些发现为临床医生提供了有关早期识别感染风险患者的新信息，也为患者提供了增强对自身风险意识的机会。
