Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; Children's Wisconsin, Milwaukee, Wisconsin; College of Nursing, Marquette University College of Nursing, Milwaukee, Wisconsin.
Children's Wisconsin, Milwaukee, Wisconsin.
Wound Manag Prev. 2021 Sep;67(9):25-32.
Medical device-related pressure injuries (MDRPIs) present a substantial safety risk for children who are hospitalized.
This study aimed to describe patient and clinical characteristics of children who develop MDRPIs related to electroencephalogram (EEG) leads, determine risk factors associated with their development, and determine if there are common risk factors that can lead to actionable strategies to reduce MDRPIs related to EEG leads.
A retrospective review was completed of the electronic health records of all 3136 children who had EEG lead placements between January 1, 2014, and April 16, 2018, at a large tertiary care children's hospital. Data abstracted included demographic variables, patient and pressure injury characteristics, as well as length of stay.
Twenty-four (24) of the 3136 children (0.8%) developed an MDRPI. Most were stage 2 pressure injuries. Patients who developed a pressure injury were significantly younger than patients who did not (median age, 0.9 and 5.2 years, respectively; P = .005). Fifty percent (50%) of all patients who developed pressure injuries were younger than 1 year of age compared with 27% of patients who did not develop pressure injuries. The median length of stay for patients in whom MDRPI developed was 84.5 days (interquartile range, 45-137) versus 3.0 days (interquartile range, 2-8) for those who did not develop an MDRPI (P < .001). The mortality rate during the hospital stay was 21% (n = 5) for those who developed MDPRIs versus 4% (n = 19) for those who did not (P = .002). All patients received standard preventive strategies.
The incidence of MDRPIs in this patient population was significantly higher in younger and longer-stay patients, and their mortality rate was significantly higher. This suggests that the patients who developed an MDRPI were more critically ill than those who did not. Vigilant assessment and more research are needed to determine if there are appropriate strategies to reduce MDRPIs related to EEG lead placement.
医疗器械相关性压力性损伤（MDRPI）给住院患儿带来了重大安全风险。
本研究旨在描述与脑电图（EEG）导联相关的 MDRPI 患儿的患者和临床特征，确定与 MDRPI 相关的危险因素，并确定是否存在共同的危险因素，从而制定出可降低与 EEG 导联相关的 MDRPI 的策略。
对 2014 年 1 月 1 日至 2018 年 4 月 16 日期间在一家大型三级儿童保健医院接受 EEG 导联放置的 3136 名儿童的电子健康记录进行了回顾性审查。提取的数据包括人口统计学变量、患者和压力性损伤特征以及住院时间。
3136 名儿童中有 24 名（0.8%）发生了 MDRPI。大多数为 2 期压力性损伤。发生压力性损伤的患者明显比未发生压力性损伤的患者年龄小（中位数年龄分别为 0.9 岁和 5.2 岁；P =.005）。所有发生压力性损伤的患者中，50%（50%）的年龄小于 1 岁，而未发生压力性损伤的患者中，这一比例为 27%（P <.001）。发生 MDRPI 的患者的中位住院时间为 84.5 天（四分位距，45-137），而未发生 MDRPI 的患者为 3.0 天（四分位距，2-8）（P <.001）。发生 MDRPI 的患者的住院期间死亡率为 21%（n = 5），而未发生 MDRPI 的患者为 4%（n = 19）（P =.002）。所有患者均接受了标准预防策略。
在该患者人群中，年轻和住院时间较长的患者 MDRPI 的发生率显著更高，死亡率也显著更高。这表明发生 MDRPI 的患者比未发生 MDRPI 的患者病情更危急。需要进行更严密的评估和更多的研究，以确定是否有适当的策略来降低与 EEG 导联放置相关的 MDRPI。
