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医院获得性压疮的特征及其发生发展的影响因素:一项回顾性研究

Characteristics of Hospital Acquired Pressure Ulcer and Factors Affecting Its Development: A Retrospective Study.

作者信息

Mortada Hatan, Malatani Nader, Awan Basim A, Aljaaly Hattan

机构信息

Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, SAU.

Department of Emergency Medicine, King Fahad General Hospital, Jeddah, SAU.

出版信息

Cureus. 2020 Dec 9;12(12):e11992. doi: 10.7759/cureus.11992.

Abstract

Background Worldwide, pressure ulcers (PUs) have been implicated in costing billions annually, with 60,000 deaths out of 2.5 million hospitalized patients resulting from complications related to PU. The prevention of PU reduces the incidence of other illnesses, decreases the financial costs, and improves the quality of life for patients. We aimed to identify the most influential factors that increased the risk of developing PUs among hospitalized patients at a university hospital according to the Waterlow scale. Methods Data were collected retrospectively from patients who developed PUs between January 2016 and December 2018 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, and were evaluated using the Waterlow PU risk assessment tool. The analysis was performed using the Statistical Package for Social Science (SPSS), version 23.0 (IBM, Armonk, NY). Results A total of 272 cases were included in this study. The highest number of cases (n = 83, 30.5%) belonged to the age group of 50 to 64 years. The majority of patients had stage 2 PUs (165, 60.7%). The most frequent location of PU was the "back" (97, 35.7%). A history of undergoing major surgery was significantly associated with a higher stage of PU (p = 0.040). The mean Waterlow PU score for all cases was 27.19 ± 13.143. There was a moderate positive correlation between the neurological deficit score and the Waterlow PU score (correlation coefficient: 0.447, p < 0.001). Multinomial logistic regression analysis revealed that increasing age is a significant predictive factor for developing higher stages of PUs (p = 0.046). Conclusion Major surgery, neurological deficit, low hemoglobin level, and increasing age were strong predictors for developing higher stages of PU. Therefore, healthcare contributors should consider these risks when applying a comprehensive PU management plan.

摘要

背景 在全球范围内,压疮每年造成的损失高达数十亿美元,在250万住院患者中,有6万人因与压疮相关的并发症死亡。预防压疮可降低其他疾病的发病率,减少经济成本,并提高患者的生活质量。我们旨在根据沃特洛量表确定在某大学医院住院患者中增加发生压疮风险的最具影响力的因素。

方法 回顾性收集2016年1月至2018年12月在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院发生压疮的患者的数据,并使用沃特洛压疮风险评估工具进行评估。分析使用社会科学统计软件包(SPSS)23.0版(IBM,纽约州阿蒙克)进行。

结果 本研究共纳入272例病例。病例数最多的年龄组为50至64岁(n = 83,30.5%)。大多数患者为2期压疮(165例,60.7%)。压疮最常见的部位是“背部”(97例,35.7%)。接受大手术史与压疮更高分期显著相关(p = 0.040)。所有病例的沃特洛压疮平均评分为27.19±13.143。神经功能缺损评分与沃特洛压疮评分之间存在中度正相关(相关系数:0.447,p < 0.001)。多项逻辑回归分析显示,年龄增长是发生更高分期压疮的重要预测因素(p = 0.046)。

结论 大手术、神经功能缺损、低血红蛋白水平和年龄增长是发生更高分期压疮的有力预测因素。因此,医疗保健人员在应用全面的压疮管理计划时应考虑这些风险。

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本文引用的文献

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Patient risk factors for pressure ulcer development: systematic review.患者发生压疮的风险因素:系统评价。
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Pressure ulcers in Jordan: a point prevalence study.约旦的压疮:一项现患率研究。
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