Servizio Cure Palliative e Hospice, Cesena, Italy.
Hospice «Valerio Grassi» e Hospice «Benedetta Bianchi Porro» U.O. Cure Palliative, Forlimpopoli, Italy.
Int Wound J. 2020 Jun;17(3):641-649. doi: 10.1111/iwj.13317. Epub 2020 Feb 11.
Pressure ulcers lead to discomfort for patients and may have an important impact on a patient's quality of life. Measure the incidence and prevalence of pressure ulcers in a Hospice environment; evaluate the risk factors associated with pressure ulcers; and calculate the incidence of Kennedy Terminal Pressure Ulcers. This multicentre prospective cohort study enrolled 440 cancer patients in advanced phase, consecutively admitted to five hospices of the AUSL della Romagna (Italy), during a period of 1 year. Five hundred more patients were excluded from the study because of inability to sign the consent form or refusal to participate. All patients were adults above 18 years of age. The National Pressure Advisory Panel Classification System was used to evaluate the pressure ulcers. Potential risk predictors were evaluated through the Braden Scale, the Numerical Scale, and the Pain Assessment in Advanced Dementia Scale. Starting in September 2016, 214 (48.6%) females and 226 (51.4%) males were analysed. The incidence of pressure ulcers in the total population was 17.3%. The risk factors that influence the development of pressure ulcers were age, proximity to death, and duration of stay in Hospice. The incidence of Kennedy Terminal Pressure Ulcers was 2.7%. This study demonstrates that 17.3% of all patients admitted to a hospice setting developed a pressure ulcer. The longer the patients stay in hospice and the clinical condition deteriorates, the higher the risk of developing a pressure ulcer.
压疮会给患者带来不适,并可能对患者的生活质量产生重要影响。在临终关怀环境中测量压疮的发生率和患病率;评估与压疮相关的危险因素;并计算肯尼迪终末期压疮的发生率。这项多中心前瞻性队列研究纳入了来自意大利 AUSL della Romagna 的五家临终关怀机构的 440 名晚期癌症患者,为期 1 年。由于无法签署同意书或拒绝参与,另外 500 名患者被排除在研究之外。所有患者均为 18 岁以上的成年人。采用国家压疮咨询小组分类系统评估压疮。通过布雷登量表、数字量表和晚期痴呆疼痛评估量表评估潜在的风险预测因素。从 2016 年 9 月开始,分析了 214 名(48.6%)女性和 226 名(51.4%)男性。总人群中压疮的发生率为 17.3%。影响压疮发生的危险因素有年龄、接近死亡和在临终关怀机构的停留时间。肯尼迪终末期压疮的发生率为 2.7%。本研究表明,在临终关怀机构接受治疗的所有患者中,有 17.3%的患者发生了压疮。患者在临终关怀机构停留的时间越长,临床状况越恶化,发生压疮的风险就越高。